Chronic pulmonary embolism
Fatigue, chronic cough
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Chronic pulmonary embolism involving the right and left pulmonary arteries extending to the lobar and segmental branches. No evidence of pulmonary infarct.
Multiple enlarged bilateral bronchial and non-bronchial systemic arteries.
The pulmonary trunk is prominent with early reflux of contrast material to the IVC and hepatic veins.
Calcified atherosclerotic plaques of the aortic arch and descending aorta without evidence of luminal narrowing or aneurysmal dilatation.
Mild bronchial dilation and bronchial wall thickening bilaterally (senile finding).
No evidence of air space consolidation nor nodule in the pulmonary parenchyma.
CT signs for chronic pulmonary embolism present in the case are:
Eccentric thrombus, post-stenotic dilatation, slightly prominent pulmonary trunk, tortuous pulmonary vessels, and signs of systemic collateral supply (enlargement of bronchial and non-bronchial systemic arteries).