Presentation
Dyspnea and chest pain. High risk on Wells criteria (score at 7). CT to rule out pulmonary thromboembolism.
Patient Data
there are multiple occlusive and non-occlusive filling defects within the pulmonary arteries of the lower lobes, upper left lobe, and middle lobe.
inferior vena cava contrast reflux
(right ventricular diameter): (left ventricular diameter) ratio >1
rounded opacification without air bronchograms in the anterior segment of the left upper lobe, demonstrating convex borders with a ground glass opacity surrounding it (halo sign)
left horizontal accessory fissure
no pleural effusion
enlarged pulmonary trunk (measruing 35 mm)
Comparison to the previous CT:
disappearance of the pulmonary consolidation and of the associated ground glass opacification involving the left upper lobe
the left horizontal accessory fissure is better seen.
the pulmonary trunk is still enlarged.
no pleural effusion
Case Discussion
Atypical features of a pulmonary infarction, presenting as a convex-bordered consolidation. The differential was lung cancer, but the follow-up demonstrated complete regression of the lesion.
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