Presentation
Fatigue and fever. Non-smoker. Chest infection?
Patient Data
Enlarged, dense right perihilar/hila outline.
The hila vessels are separately identified (hilum overlay sign).
Left lung clear.
A rpt film 6 wk after...
A rpt film 6 wk after antibiotic Rx
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 - the abnormality is perihilar in location and the history of fever in a young non-smoker is strong for infection.
A confident and sensible clinician has given appropriate treatment (antibiotics in this case) and a follow up chest x-ray with a normal 6-week film confirming infection rather than performing a knee-jerk CT chest.