Cheerio Sign

NODULES OF WEGENER”S GRANULOMATOSIS, aka GRANULOMATOSIS WITH POLYANGIITIS, GPA
65 year old female presents with epistaxis and with nodular changes on CXR (a) magnified in b.
CT scan in axial projection (c) and magnified in d, reveals 3 types of nodules.
A spiculated solid nodule (red arrow head) is magnified in e, a bronchocentric nodule (teal arrowhead) is magnified in e. This may represent a cavitating nodule or hemorrhagic change around a bronchiole (cheerio sign) A ground glass nodule (white arrowhead) is magnified in g.
Ashley Davidoff MD

 

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