Clinical Presentation

A 4-year-old with hoarseness.

(A,B) Axial computed tomography (CT) images demonstrate multiple soft-tissue masses throughout both lungs (arrows). Notice the mural soft-tissue mass in the trachea (arrowhead).

Differential Diagnosis

• Papillomatosis: Soft-tissue masses within the airway as well as nodules in the lungs indicate papillomatosis.

• Metastatic disease: Wilms tumor frequently metastasizes to the lung, but the airway is not usually involved.

• Invasive fungal disease: These soft-tissue masses may have a ground-glass halo and occur in immunocompromised individuals. Also, they do not involve the trachea.