A 50-year-old patient with known malignancy presents with multiple bilateral pulmonary nodules on CT. The nodules are of varying sizes, well-defined, and show a predilection for the lung bases and peripheral subpleural regions. Which of the following is the most likely etiology?
- A Hematogenous pulmonary metastases ✓
- B Granulomatous infection (miliary pattern)
- C Pulmonary hamartomas
- D Rheumatoid nodules
Correct answer: A. Hematogenous pulmonary metastases
Explanation
Hematogenous pulmonary metastases classically present as multiple, well-defined, rounded nodules of varying size with a basal and peripheral predilection (due to higher blood flow to the lung bases). Miliary tuberculosis shows uniformly sized, diffuse 1-3 mm nodules. Hamartomas are usually solitary. Rheumatoid nodules are peripheral and may cavitate but are associated with rheumatoid arthritis and joint disease.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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