Thursday, April 10, 2014

Pulmonary Embolism


In the right lower hemithorax ( near the costophrenic angle ), we can see a rounded opacity there. This is consolidation due to pulmonary infarction. Patient has positive D-dimer and CTPA reveals a saddle embolus 

Learning point: Consolidation can be due to 
1) Pus - pneumonia
2) Blood - infarction, hemorrhage, contusion
3) Fluid - pulmonary edema

Bonus point :
It will be useful to know acute vs chronic consolidation by the old film and the duration of patient's symptoms
As chronic consolidation will ONLY consists of a few ddx:
1) Main one is neoplasm ( adenocarcinoma in situ, lymphoma )
2) Chronic post infectious disease eg organizing pneumonia, chronic eosinophilic pneumonia )
3) Alveolar proteinosis
4) Sarcoidosis ( not exactly consolidation but numerous nodular opacities causing a consolidation like pattern )

Enjoy the weekend !!

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