Calcified lung nodules are frequently encountered on chest imaging, often as incidental findings. While calcifications are typically associated with benign conditions, they do not inherently exclude malignancy, making accurate differentiation essential. The primary diagnostic challenge lies in distinguishing benign from malignant nodules based solely on imaging features. Various calcification patterns, including diffuse, popcorn, lamellated and eccentric, provide important diagnostic clues, though overlap among different conditions may persist. A comprehensive diagnostic approach integrates clinical history with multimodal imaging, including magnetic resonance and nuclear medicine, when necessary, to improve accuracy. When imaging findings remain inconclusive, tissue sampling through biopsy may be required for definitive characterization. This review provides an overview of the imaging features of calcified lung nodules, emphasizing key diagnostic challenges and their clinical implications.

Sarcoidosis is a chronic, idiopathic, multisystemic inflammatory disease characterized by non-caseating granulomas, most commonly affecting the lungs and mediastinal lymph nodes. Radiological imaging plays a fundamental role in the diagnosis, assessment of disease extent, and differentiation from other pulmonary conditions. This narrative review offers a comprehensive overview of the imaging features of pulmonary sarcoidosis, focusing on both typical patterns—such as bilateral hilar lymphadenopathy, perilymphatic nodules, and upper lobe-predominant infiltrates—and atypical manifestations—including alveolar opacities, miliary nodules, fibrocystic changes, and lower lobe involvement. Emphasis is placed on the utility of high-resolution computed tomography (HRCT) in detecting early parenchymal changes and complications such as fibrosis, bronchiectasis, and pulmonary hypertension. Differential diagnosis, including tuberculosis, silicosis, metastatic disease, organizing pneumonia, and hypersensitivity pneumonitis, are discussed to aid interpretation. Recognizing the spectrum of radiological presentations is essential for distinguishing sarcoidosis from other interstitial and granulomatous lung diseases. Radiologists play a pivotal role in the multidisciplinary diagnostic process, contributing to timely diagnosis, risk stratification, and optimized patient management.

Background/Objectives: Malignant pleural mesothelioma (MPM) is a rare, aggressive cancer linked to asbestos exposure and with poor overall survival. In recent years, CT volumetric analysis has gained increasing interest as a more accurate method for assessing tumor burden. This study aims to evaluate the prognostic value of chest CT volumetric analysis in MPM, comparing tumor volume with tumor thickness measurements and survival outcomes. Methods: This is a retrospective, observational analysis of all patients undergoing diagnostic thoracoscopy between 2014 and 2021 at the University Hospital of Cattinara (Trieste, Italy). Inclusion criteria were as follows: age ≥ 18 years, histological diagnosis of MPM, and the availability of at least one contrast-enhanced chest CT scan at the time of diagnosis. For each patient, the tumor thickness was measured on the axial plane at three levels (upper, middle, and lower hemithorax). Tumor and effusion volumes were calculated with the RayStation^® software version 11.7.174 (HealthMyne^®, Madison, WI, USA). Results: A total of 81 patients were eligible for analysis. Maximum and mean tumor thickness were strongly associated with survival, with higher thicknesses correlating with an increased risk of death (adjusted hazard ratio per doubling (aHR) of 1.97 (95%CI: 1.40–2.77) and of 2.23 (95%CI: 1.56–3.20), p < 0.001)), respectively, while the effect of the tumor volume on survival was nevertheless significant but less impactful (aHR = 1.26 (1.10–1.45, p < 0.001)). The presence and volume of effusion did not correlate with survival (p = 0.48 and p = 0.64, respectively). Conclusions: This study supports the role of quantitative parameters for staging MPM, particularly given the frequent discrepancies between clinical and pathological staging when relying solely on qualitative measures.