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Pulmonary abscess

Case contributed by Hidayatullah Hamidi
Diagnosis almost certain

Presentation

History of hemoptysis for the last few days. Fever, cough, and weight loss of one month. Lab results: WBC: 19400, Neutrophils: 87%, AFB: negative ESR: 35.

Patient Data

Age: 10 years
Gender: Male
x-ray

Ill-defined opacity in the right lower lung zone with features of central lucency.

ct

An ill-defined hypoattenuating lesion with internal mixed fluid and air contents as well as surrounding marked pneumonitic changes in the right lung lower lobe posterobasal segment. The lesion is measuring about 6.3 x 4.8 x 5 cm. There is evidence of bronchial communication of this lesion. Peripheral calcification is seen in the region.
Multiple enlarged right paratracheal, right hilar, and subcarinal lymph nodes are seen. The largest subcarinal lymph node measures 1.4 cm in short diameter.

Case Discussion

Findings in keeping with pneumonia, lung necrosis and abscess formation.

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