CT Chest in Cavitary Lung Disease: Looking Beyond the Lungs

[摘要] Figures Figure 1 Septic pulmonary embolism. A, Contrast-enhanced CT scan of the chest in a 20-year-old male patient revealed bilateral pleural effusion with cavitating nodules (B, white arrow). In addition, a small intramuscular collection was seen in paraspinal muscles on the patient’s right side (A, black arrow). Also note a small hypodense filling defect in azygous vein suggestive of thrombosis (A, white arrow). Based on these findings, a diagnosis of septic pulmonary embolism was made. Intramuscular abscesses were thought to be the primary source of infection. Blood culture and pus culture from the abscess was positive for methicillin-resistant Staphylococcus aureus. Figure 2 Mediastinal lymphadenopathy in pulmonary TB. Axial mediastinal window sections of contrast-enhanced CT scan of the chest shows pulmonary TB in two patients. A, Enlarged necrotic lymph nodes are seen in prevascular and pretracheal location with peripheral enhancing rim (white arrow). A cavitary lesion is also seen in the left lung. Also note the presence of a small calcific focus in pretracheal lymph node. B, Calcified subcarinal lymph nodes in another patient (white arrow), with healed pulmonary TB. We read with great interest the review article published in this issue of CHEST entitled “Cavitary Lung Diseases: A Clinical-Radiologic Algorithmic Approach.”¹ The authors provided an approach for diagnosis of cavitary lung disease based on etiology, duration, clinical features, and imaging findings on CT of the chest. We found the article very informative and would like to congratulate the authors for a comprehensive review of various entities that produce cavitary lung disease.

[学科分类] 呼吸医学