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Pulmonary embolism

Case contributed by Ammar Haouimi
Diagnosis almost certain


History of surgery for femoral fracture 4 weeks prior, presented with dyspnea, cough and left thoracic pain.

Patient Data

Age: 70 years
Gender: Female

Filling defects of the left main pulmonary artery extending into the lobar arteries and their segmental branches mainly in the left lower lobe with thin rim of contrast around the central filling defect "polo mint sign"

Filling defects of the dorsal branch of the right upper lobar artery and right lower lobar artery and its segmental branches.

Minimal left pleural effusion with triangular shaped peripheral pulmonary opacities of the lower lobe (result of lung infarction secondary to pulmonary embolism). Dilated left atrium with mitral valve calcification.

Sliding hiatal hernia is noted.

Case Discussion

CT features of an acute pulmonary embolism complicated by lung infarct (the D-dimer level was at 4530 ng/mL in this case).

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