Tree in bud
79 year old lady with emphysema and shortness of breath. Exclude PE.
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The CTPA demonstrates a small peripheral right-sided pulmonary embolus, but more significant is the widespread terminal bronchial plugging and bronchial wall thickening. Lingular atelectasis may be a chronic finding.
Certainly, the cause of her symptoms is more likely to be the terminal bronchial plugging (with tree in bud appearance) rather than the tiny PE.