• Adriana Scamporlino, Maria Cecilia Mengoli, Olga Calabrese, Giovanni Della Casa, Beatrice Aramini, Andrea Spallanzani, Uliano Morandi, and Alessandro Stefani.
• Thoracic Surgery Unit, University Hospital of Modena, Modena, Italy. Electronic address: adrianascamporlino@gmail.com.
• Chest. 2019 Oct 1; 156 (4): e85-e89.

Case PresentationA 72-year-old man underwent endoscopic resection of a 10-mm polypoid sessile lesion of the rectum. Histologic examination found a well-differentiated, low-grade (G1), neuroendocrine tumor. A thoracoabdominal CT scan was performed for staging purposes. The chest CT scan revealed a so-called cannonball-like distribution of multiple rounded nodules, with well-defined margins, ranging from 0.5 to 5 cm, scattered in both lungs (Figs 1A, 1B). The abdominal CT scan showed no abnormalities. A recent colonoscopy showed no evidence of malignancy. No prior chest imaging was available and the patient had never complained of respiratory symptoms. The patient was a former smoker, with a smoking history of 20 pack-years. He had a history of hypertension, mild stenosis of both carotid arteries, and benign prostatic hypertrophy. He reported the presence of long-standing multiple cutaneous hemangiomas on the trunk and face and a larger hemangiomatous lesion on his left lower limb, which was previously investigated by color Doppler ultrasound imaging. All these lesions were reported as unaltered and unchanged since early infancy.Copyright © 2019 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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