PMC7370325_01
Chest X-ray displays protruding masses in both hilar areas (white arrowheads) and small nodules (black arrowheads) in both lung fields.
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A chest X-ray (Fig. 1) revealed protruding masses in both hilar areas.
Chest computed tomography scan (CT). (A)-(C) These images reveal several round and evenly distributed nodules (black arrowheads) that spread evenly over both lungs without airway obstruction. (D)-(E) It shows bilateral mediastinal and hilar lymphadenopathy without calcification (white arrowheads).
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In a computerized tomography (CT) scan of the chest (Fig. 2), multiple rounded nodules less than 1 cm in size were found in both lungs, evenly in both upper lobes, lower lobes, and right middle lobes.
(A) Bronchoscopy. There is no bronchial anthracotic pigmentation or narrowing. (B) 18F Fluorodeoxyglucose (18F FDB) Positron emission tomography (PET) scan shows that the maximum SUV was 5.96 in hilar and mediastinal lymph nodes and 2.49 in the pulmonary nodules.
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Bronchoscopy (Fig. 3A) showed no endobronchial lesions and no pigment. PET scan (Fig. 3B) was accompanied by F-18 fluorodeoxyglucose (18F FDG) uptake with a maximum standardized uptake value (SUV) of 2.49 in multiple lung nodular lesions, and 18F FDG uptake in bilateral hilar and mediastinal LN at a maximum SUV of 5.96.
(A) Gross appearance of pigmented pulmonary nodules in wedge resection of 0.5X0.4 cm. (B)-(C) Photomicrograph of pulmonary nodules showing anthracotic pigmentation and fibrosis in wedge biopsy (B,H&E 20x; C, H&E 100x).
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Histopathologic examination (Fig. 4) revealed lung nodules were anthracofibrosis, and LN was reactive hyperplasia.