Presentation
Emphysema and shortness of breath. Exclude PE.
Patient Data
Age: 80 years
Gender: Female
From the case:
Tree-in-bud appearance
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Lingular collapse and widespread plugging of the teminal bronchi. Small peripheral right-sided pulmonary embolus.
Case Discussion
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.