Pulmonary infarction

Case contributed by Ian Bickle
Diagnosis almost certain


Shortness of breath and left pleuritic chest pain. Raised D-dimer.

Patient Data

Age: 55 years
Gender: Female

Embolus in the segmental branches of the left lower lobe pulmonary artery.

The left lower lobe is normal in appearance.

2 days following the ...


2 days following the diagnosis of a PE a CT abdomen for alternative purposes.

Wedge shaped area of consolidation in the left lower lobe corresponding to the lung supplied by the segmental artery, which contained the embolus on the earlier CT study.

This has developed in the 2 days between studies as the last CT showed normal appearances of the left lower lobe.

Case Discussion

Pulmonary embolus is common, and with the widespread availability of CTPA is a daily radiological issue.

In a small proportion of cases a pulmonary infarction is identified, although not always on the initial diagnostic study.

An infarct is typically wedged shaped with the base at the periphery of the lung and apex towards the hilum.  Infarcts may cavitate.

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