Try it
General Medicine · Respiratory medicine: pulmonary hamartoma
Sample itemA routine chest radiograph in a 50-year-old non-smoker shows a 2 cm round, well-circumscribed nodule with scattered popcorn-like calcification. It is unchanged from a film taken 3 years ago. What is the most likely diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Pulmonary hamartoma
Pulmonary hamartoma is the commonest benign lung tumour. It contains cartilage and fat and has a smooth margin, with popcorn calcification in a minority. Stability over 2 years or more and benign calcification patterns favour a benign nodule.
Option by option
A. Pulmonary hamartoma (correct)
Correct. A stable smooth nodule with popcorn calcification is characteristic of hamartoma.
B. Bronchial carcinoid tumour
A carcinoid is typically a central endobronchial lesion causing obstruction.
C. Metastasis from colonic carcinoma
A metastasis is usually multiple and enlarges over time, and rarely calcifies in this pattern.
D. Bronchogenic adenocarcinoma
Adenocarcinoma usually has an irregular or spiculated margin and grows over time.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
More General Medicine questions
- EndocrinologyA 19-year-old with type 1 diabetes presents with vomiting, deep rapid breathing, fruity…
- ElectrolytesWhich is the earliest ECG change in hyperkalaemia?
- Infectious diseaseWhat is the drug of choice for Pneumocystis jirovecii pneumonia in a patient with advanc…
- NeurologyA chronic alcohol user is brought in confused, with nystagmus and an unsteady gait. What…