MCQs: Calcified Lymphadenopathy in the Chest
1. What is the most common cause of calcified lymphadenopathy in the chest?
A. Sarcoidosis
B. Tuberculosis
C. Silicosis
D. Papillary thyroid carcinoma
Answer: B. Tuberculosis
Comment: Tuberculosis is the most common cause of calcified lymphadenopathy in the chest, particularly in regions endemic for TB.
?Calcification within lymph nodes commonly results from healed granulomatous infections such as tuberculosis and histoplasmosis.?
Reference: Radiopaedia: Calcified Nodes
2. Which of the following calcification patterns is most characteristic of silicosis?
A. Central calcifications
B. Eggshell calcifications
C. Eccentric calcifications
D. Psammommatous calcifications
Answer: B. Eggshell calcifications
Comment: Silicosis often presents with eggshell calcifications, characterized by thin peripheral calcifications of lymph nodes.
?Eggshell calcification of lymph nodes is a hallmark of silicosis, often seen in the mediastinum and hilar regions.?
Reference: PubMed: Eggshell Calcifications
3. Psammommatous calcifications in thoracic lymph nodes are most commonly associated with which condition?
A. Sarcoidosis
B. Papillary thyroid carcinoma
C. Histoplasmosis
D. Tuberculosis
Answer: B. Papillary thyroid carcinoma
Comment: Psammommatous calcifications are lamellated, round structures seen in metastatic lymph nodes, particularly from papillary thyroid carcinoma and mucinous adenocarcinomas.
?Psammommatous calcifications are a distinctive feature of papillary thyroid carcinoma and some mucinous adenocarcinomas.?
Reference: Radiographics: Thoracic Calcifications
4. Which of the following conditions most commonly presents with lobulated calcifications in lymph nodes?
A. Castleman disease
B. Silicosis
C. Tuberculosis
D. Sarcoidosis
Answer: A. Castleman disease
Comment: Castleman disease can produce lobulated calcifications due to chronic inflammatory and lymphoproliferative changes.
?Lobulated calcifications are characteristic of Castleman disease, reflecting chronic lymph node changes.?
Reference: Radiopaedia: Castleman Disease
5. Which imaging modality is most effective in differentiating benign from malignant calcified lymph nodes?
A. Chest X-ray
B. High-resolution CT (HRCT)
C. PET-CT
D. Ultrasound
Answer: C. PET-CT
Comment: PET-CT is effective in distinguishing benign calcified lymph nodes (low metabolic activity) from malignant nodes (increased metabolic activity).
?PET-CT helps differentiate benign from malignant lymph nodes by assessing metabolic activity, with benign calcifications typically demonstrating low FDG uptake.?
Reference: PubMed: PET-CT in Calcified Nodes
6. Which type of calcification is most commonly seen in sarcoidosis?
A. Psammommatous calcifications
B. Eggshell calcifications
C. Central calcifications
D. Eccentric calcifications
Answer: B. Eggshell calcifications
Comment: Sarcoidosis can present with eggshell calcifications, often associated with bilateral hilar and mediastinal lymphadenopathy.
?Eggshell calcifications, while rare, are occasionally seen in sarcoidosis, particularly in the hilar lymph nodes.?
Reference: Radiopaedia: Sarcoidosis
7. Eccentric calcifications in lymph nodes are most often associated with which condition?
A. Silicosis
B. Metastatic disease
C. Tuberculosis
D. Histoplasmosis
Answer: B. Metastatic disease
Comment: Eccentric calcifications occur in metastatic lymphadenopathy, often due to neoplastic processes such as treated cancers.
?Eccentric calcifications are a feature of metastatic disease, reflecting dystrophic calcification within involved nodes.?
Reference: Radiopaedia: Metastatic Calcifications
8. In which granulomatous disease is central calcification in lymph nodes most likely?
A. Sarcoidosis
B. Tuberculosis
C. Silicosis
D. Amyloidosis
Answer: B. Tuberculosis
Comment: Central calcification is a hallmark of healed tuberculosis, reflecting the chronic inflammatory process.
?Central calcifications within lymph nodes are most frequently seen in healed granulomatous infections like tuberculosis and histoplasmosis.?
Reference: PubMed: Central Calcifications
9. Which metabolic disease is associated with irregular calcifications in lymph nodes?
A. Castleman disease
B. Amyloidosis
C. Sarcoidosis
D. Silicosis
Answer: B. Amyloidosis
Comment: Amyloidosis can produce irregular calcifications in lymph nodes due to chronic protein deposition and associated fibrosis.
?Irregular calcifications in lymph nodes are characteristic of amyloidosis, reflecting chronic deposition of amyloid proteins.?
Reference: Radiographics: Amyloidosis
10. What is the most characteristic feature of calcified lymph nodes due to histoplasmosis?
A. Psammommatous calcifications
B. Central calcifications
C. Eggshell calcifications
D. Eccentric calcifications
Answer: B. Central calcifications
Comment: Central calcifications are typical of histoplasmosis, reflecting healed granulomatous infection.
?Central calcifications in lymph nodes are most characteristic of healed histoplasmosis, often seen in endemic areas.?
Reference: Radiopaedia: Histoplasmosis