Description 

A 43-year-old Caucasian woman presented to her primary care physician for a retirement physical exam. She endorsed mild dyspnoea on exertion, but denied chest pain, cough or shortness of breath at rest. On physical exam, lungs were clear bilaterally with good air movement in all fields. Chest radiograph was normal except for a 6 mm nodular density noted in the right lower lobe. A non-contrast CT scan of the chest was performed revealing a 2 mm calcified granuloma. In addition, there were global, mild and uniform paraseptal emphysematous changes throughout the pleural surfaces of the lungs and the fissures (figures 1 and 2). Pulmonary work-up including spirometry, carbon monoxide diffusing …