Secondary pulmonary lobules outlined by aspiration
MVA high-speed into tree with LOC and multiple injuries.
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Centrilobular ground glass opacity most prominent within the right middle lobe but present also in the upper & lower lobes & in the left lower lobe. In addition patchy peripheral opacity is seen especially on the right in the middle lobe. The pattern suggests endobronchial process & is seen in hypersensitivity pneumonitis & aspiration & endobronchial infection. In the current setting, it is likely to be due to aspiration, especially as debris is noted in the trachea.
Conventional aortic arch anatomy. No traumatic aortic injury. No pneumothorax. No pleural or pericardial effusion.
No axillary or mediastinal lymphadenopathy. No rib fracture seen. A 15mm soft tissue nodule is identified in the right parahilar region projecting into and deforming the left lower bronchus distal to the origin of the superior segmental bronchus and at the level of its division into the basal segmental bronchi. DDx includes carcinoid tumor and lymphadenopathy.