May 2021 Imaging Case of the Month: A Growing Indeterminate Solitary Nodule

• Main Authors: Joseph Jeehoon Kim, MD, Kenneth K. Sakata, MD, Natalya Azadeh, MD, MPH, Maxwell Smith, MD, Michael B. Gotway, MD
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2021-05-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: michaelis-gutmann bodies; cardiac transplantation; heart transplant; immunocompromised host; lung biopsy; lung nodule; malakoplakia; nodule; pulmonary nodule; solitary nodule
• Online Access: https://www.swjpcc.com/imaging/2021/5/1/may-2021-imaging-case-of-the-month-a-growing-indeterminate-s.html

No abstract available. Article truncated after 150 words. A 58-year-old woman with a history of orthotopic heart transplant, performed for Adriamycin-induced cardiomyopathy, treated with mycophenolate and tacrolimus, presented for routine interval follow up. The patient’s past medical history was significant for follicular thyroid carcinoma treated with total thyroidectomy and bilateral breast carcinoma in remission as well as hypothyroidism and type II diabetes mellitus. In addition to tacrolimus and mycophenolate, the patient’s medications included aspirin, insulin, itraconazole (for anti-fungal prophylaxis), levothyroxine, prednisone (tapering since transplant), and valganciclovir. The patient recently complained of rhinorrhea and cough productive of brown-tinged sputum, improving over the previous 2 weeks; she denied fever, chills, shortness of breath, night sweats chest pain, or gastrointestinal symptoms. Physical examination showed the patient to be afebrile with normal heart and respiratory rates and blood pressure. Her room air oxygen saturation was 99%. The patient’s complete blood count and serum chemistries showed largely normal values, with the white blood …