Right upper lobe consolidation and cardiomegaly

Case contributed by Dr Jeremy Jones

Presentation

Cough and increased work of breathing.

Patient Data

Age: 5 years
Gender: Male

There is cardiomegaly and right upper lobe consolidation. The consolidation is most likely due to infection, but the heart size is large and further evaluation should be considered.

Annotated image

The horizontal fissure is the lower margin of the right upper zone opacification meaning that it is within the right upper lobe. The fact that the location of the fissure has not changed suggests that this is due to a process that is preserving lung volume (consolidation) rather than one that reduces volume (atelectasis).

Annotated image

Case Discussion

There is obvious cardiomegaly, which in this case was demonstrated to be secondary to a pericardial effusion on an echocardiogram.

The prominence of the left atrium is not uncommonly seen in paediatric patients and is not necessarily pathological. It shouldn't be misinterpreted as a mediastinal mass.

There is infective right upper lobe consolidation.

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Case information

rID: 23984
Case created: 22nd Jul 2013
Last edited: 22nd Oct 2016
Inclusion in quiz mode: Included

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