Pulmonary embolism with "bubbly consolidation" - pulmonary infarct

Case contributed by Charlie Chia-Tsong Hsu
Diagnosis almost certain


Shortness of breath, pleuritic chest pain radiating to the back. Emergency physician requested a CT aortogram for suspected aortic dissection.

Patient Data

Age: 70 years
Gender: Male

CT thorax arterial phase shows pulmonary emboli in the right lateral and posterior basal segmental arteries. The lateral basal segmental artery is completely occluded and the posterior basal segmental artery nearly occluded. There is pulmonary infarction of the right lateral and posterior basal segments.

Background findings of centrilobular/subpleural emphysema and congestive cardiac failure with interstitial pulmonary edema and bilateral pleural effusion.

Case Discussion

In pulmonary infarction the rounded lucencies represent aerated pockets of acini and/or secondary pulmonary lobules within the hemorrhagic lung. Dr John Ayres, FRCR (Eng), cleverly coined the term “bubbly consolidation”.

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