Presentation
Flu like symptoms and right pleuritic chest pain.
Patient Data
Heart size is within normal limits. Parahilar soft tissue density , mass vs lymphadenopathy. Widespread airspace opacity throughout the right lung. Prominent interstitial opacity throughout the right lung. Small right pleural effusion.
Conclusion: The appearances suggest right parahilar mass or lymphadenopathy with possible lymphatic obstruction.
There is extensive left sided mixed alveolar and interstitial opacification, progressed since yesterday. Appearance favors significant pneumonia. Right hilar soft tissue density is less well defined on today's study.
The heart size, mediastinal contours and pulmonary vascular pattern are normal. The lungs and pleural spaces are clear. There is no evidence of a pulmonary mass, infiltrates or pneumothorax.
Case Discussion
Often the initial imaging of a patient's illness can be quite non-specific, with a broad differential that includes malignant and non-malignant conditions. In many cases the evolution of the underlying process is as important as the findings at each point in time, as in this case where the initial imaging was suggestive of a hilar mass but subsequent imaging showed rapid progression to a diffuse consolidative process. The complete resolution after treatment is in keeping with an infective process.
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