Smoking related lung changes

Case contributed by Melbourne Uni Radiology Masters
Diagnosis almost certain

Presentation

Fevers with increasing shortness of breath. Heavy cigarette and marijuana usage. Fungi isolated from sputum.

Patient Data

Age: 40-year-old
Gender: Male

CT Chest

ct

In the medial basal segment of the left lower lobe, there is a 5 mm nodule adjacent to the pleura, which is stable. There is a background of severe bullous emphysema, particularly in the apices. Linear atelectasis is present within the left lung base in particular. There is no lymphadenopathy above the diaphragm. Malunited right posterior fifth rib fracture, new since previous CT. No destructive bone lesion.

Case Discussion

This young man with a long history of heavy cigarette and marijuana abuse had fungi isolated from sputum.

The imaging findings show extensive upper lobe bullous disease and established changes of emphysema.

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