Pulmonary hepatic nodules.

To cite: Talanow R, Hatipoglu US, Graham R. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/ bcr-2012-006867 DESCRIPTION A young woman presented with three pulmonary nodules identified in the right lower lobe discovered on an outside CT scan of the abdomen which was performed to investigate right flank pain. The pain was ascribed to urinary tract infection and resolved over the next few days. These lesions were not present on a CT scan obtained 3 years before. A dedicated CT of the chest confirmed the lesions which were between 1.8 and 2.5 cm in size and located along the diaphragm (figure 1A). No mediastinal lymphadenopathy or other lung lesions were identified. Initially a CT-guided biopsy of one of the lesions was planned; however, the radiologist raised the suspicion that these might represent liver parenchyma herniated through the diaphragm. Subsequently a sulfur colloid scan was performed (5.5 mCi technetium 99 IV) and planar as well as single-photon emission CT (SPECT)-CT images were obtained (figure 1 B-H). SPECT-CT images identified three soft tissue nodules on CT near the right lung base at the posterior right liver dome