Halo sign on high resolution CT: findings in spectrum of pulmonary diseases with pathologic correlation

The halo sign in a pulmonary nodule refers to the condition in which soft tissue attenuation of a pulmonary nodule is surrounded by peripheral ground glass attenuation on high resolution CT. The halo sign can be caused by several pathologic processes: hemorrhagic pulmonary nodules, tumor cell infiltration, and nonhemorrhagic inflammatory lesions. Hemorrhagic pulmonary nodules may occur in infectious diseases including invasive pulmonary aspergillosis, mucormycosis, and candidiasis and noninfectious diseases including Wegener granulomatosis and primary and metastatic hemorrhagic tumors. Tumor cell infiltration in bronchioloalveolar carcinoma, pulmonary lymphoma, and pulmonary metastatic neoplasm may appear with the halo sign. Eosinophilic lung disease and organizing pneumonia are representative of inflammatory lesions showing the sign.