Pulmonary emboli and lung infarction with Hampton hump

Case contributed by Dr Matthew Lukies

Presentation

Left sided pleuritic chest pain and right calf pain

Patient Data

Age: 30 years
Gender: Female

The chest x-ray demonstrates the Hampton hump sign, a dome-shaped area of opacification in the periphery of the left lower lobe.

  • Pulmonary emboli in the right middle and lower lobar branches, as well as the right lower lobe lateral and posterior segmental branches
  • Pulmonary emboli in the left lower lobe branch and left lower lobe superior, anteromedial, lateral and posterior segmental branches
  • Area of consolidation with internal air lucencies in the left lower lobe lateral segment representing lung infarction

Case Discussion

This case demonstrates the Hampton hump sign with a subsequent CTPA confirming the diagnosis of pulmonary emboli with lung infarction in the area corresponding to the left lower lobe peripheral opacity on chest x-ray.

Risk factors for pulmonary embolism in this patient were:

  • recent long overseas flight
  • smoking
  • oral contraceptive pill

A subsequent ultrasound confirmed the presence of a unilateral lower limb DVT in the right peroneal and popliteal veins.

The patient was commenced on a factor Xa inhibitor anticoagulant medication, smoking cessation encouraged and the oral contraceptive pill was ceased.

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