Perihilar consolidation - with follow up film resolution

Case contributed by Dr Ian Bickle

Presentation

Fatigue and fever. Non-smoker. Chest infection?

Patient Data

Age: 40 years
Gender: Female

Enlarged, dense right perihilar/hila outline.

The hila vessels are separately identified (hilum overlay sign)

Left lung clear.

A repeat film was performed 6 weeks after antibiotic therapy.

X-ray

Heart size normal.

Lungs clear.

Complete resolution of the right perihilar consolidation.

Case Discussion

One the initial review of the first film the hilum looks dense and enlarged with the immediate concern for malignancy.

On closer interrogation it is perihilar in nature and the history in a young non-smoker if strong for infection.

A confident and sensible clinician has given appropriate treatment and a follow up chest x-ray with a normal 6 week film confirming infection rather than performing a knee-jerk CT chest. 

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