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Intralobar Pulmonary Sequestration

Giberman AG - MedPix (2010)

View Article: MedPix Image - MedPix Case

Affiliation: Naval Medical Center San Diego

ABSTRACT

Diagnosis: Intralobar Pulmonary Sequestration

History: 22-year-old woman with history of recurrent pulmonary infections presents with cough for 2.5 weeks, fever, intermittent sputum production, but no hemoptysis

Findings: 1st Image: PA and lateral radiographs of the chest demonstrate patchy air space density involving the right lower lobe. There is a cavitary lesion with an air-fluid level worrisome for abscess formation. The remainder of the lung parenchyma is clear and evenly aerated without additional regions of consolidation identified. There is focal extroconvex curvature involving the thoracic spine, unchanged. Next 3 images: Within the right lung base there is a large area of consolidation with accompanying bronchiectasis as well as a cavitary lesion with an air fluid level. Several additional areas of patchy opacity are present likely representing accompanying atelectasis. There is no evidence of pneumothorax or pleural effusion. No enlarged lymph nodes are identified. Last image: There is a cluster of well-defined thin-walled cysts in the right lung base, some of which are confluent. The previously noted marked soft tissue thickening around them has resolved during the study interval as has the air-fluid level. No soft tissue thickening persists in this region. The lungs are otherwise clear.

Ddx: Congenital lesions- Intralobar pulmonary sequestration blebs bullae pneumatoceles traumatic lesions coccidioidomycosis Pneumocystis jiroveci pneumonia hydatid disease metastatic malignant lesions bronchogenic carcinomas lymphomas infections and abscesses (bacterial, fungal) Wegener granulomatosis rheumatoid nodule pulmonary infarct septic embolism progressive massive fibrosis with pneumoconiosis lymphocytic interstitial pneumonia bronchiectasis congenital lesions pulmonary lymphangioleiomyomatosis pulmonary Langerhans cell histiocytosis honeycomb lung associated with advanced fibrosis

Dxhow: Surgical removal of sequestered lung tissue

Exam: Egophony was heard on the right lower/mid lung field. Labs within normal limits, no leukocytosis.

No MeSH data available.


Cavitary lesion in the right lower lobe (RLL)
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MPX1610_synpic51799: Cavitary lesion in the right lower lobe (RLL)


Intralobar Pulmonary Sequestration

Giberman AG - MedPix (2010)

Cavitary lesion in the right lower lobe (RLL)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1610&req=5

MPX1610_synpic51799: Cavitary lesion in the right lower lobe (RLL)

View Article: MedPix Image - MedPix Case

Affiliation: Naval Medical Center San Diego

ABSTRACT

Diagnosis: Intralobar Pulmonary Sequestration

History: 22-year-old woman with history of recurrent pulmonary infections presents with cough for 2.5 weeks, fever, intermittent sputum production, but no hemoptysis

Findings: 1st Image: PA and lateral radiographs of the chest demonstrate patchy air space density involving the right lower lobe. There is a cavitary lesion with an air-fluid level worrisome for abscess formation. The remainder of the lung parenchyma is clear and evenly aerated without additional regions of consolidation identified. There is focal extroconvex curvature involving the thoracic spine, unchanged. Next 3 images: Within the right lung base there is a large area of consolidation with accompanying bronchiectasis as well as a cavitary lesion with an air fluid level. Several additional areas of patchy opacity are present likely representing accompanying atelectasis. There is no evidence of pneumothorax or pleural effusion. No enlarged lymph nodes are identified. Last image: There is a cluster of well-defined thin-walled cysts in the right lung base, some of which are confluent. The previously noted marked soft tissue thickening around them has resolved during the study interval as has the air-fluid level. No soft tissue thickening persists in this region. The lungs are otherwise clear.

Ddx: Congenital lesions- Intralobar pulmonary sequestration blebs bullae pneumatoceles traumatic lesions coccidioidomycosis Pneumocystis jiroveci pneumonia hydatid disease metastatic malignant lesions bronchogenic carcinomas lymphomas infections and abscesses (bacterial, fungal) Wegener granulomatosis rheumatoid nodule pulmonary infarct septic embolism progressive massive fibrosis with pneumoconiosis lymphocytic interstitial pneumonia bronchiectasis congenital lesions pulmonary lymphangioleiomyomatosis pulmonary Langerhans cell histiocytosis honeycomb lung associated with advanced fibrosis

Dxhow: Surgical removal of sequestered lung tissue

Exam: Egophony was heard on the right lower/mid lung field. Labs within normal limits, no leukocytosis.

No MeSH data available.