Chronic pulmonary embolism

Case contributed by Dr Hidayatullah Hamidi

Presentation

Fatigue, chronic cough

Patient Data

Age: 75 years
Gender: Male
CT

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.

Case Discussion

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).

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Case information

rID: 91241
Published: 14th Jul 2021
Last edited: 18th Jul 2021
System: Chest, Cardiac
Inclusion in quiz mode: Included

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