Uncategorized

Infection Inflammation Malignancy Mechanical/Atelectasis Trauma Metabolic Circulatory- Hemorrhage Immune Infiltrative Idiopathic Iatrogenic Idiopathic

Infection

Abscess

Cavitating Mass Left Upper Lobe – Culture Confirms Abscess 
72-year-old female presents with cough, fever and leukocytosis
The CT confirms a peripheral subsegmental consolidation in the posterior segment of the LUL with cavitation (b and d white arrowheads. There is surrounding ground glass change reflecting surrounding edema (d, red arrowheads). Cultures confirmed bacterial abscess
Ashley Davidoff MD TheCommonVein.net 261Lu 118357cL
CT ? Left Upper Lobe Lung Abscess Biopsy and Culture
72-year-old female presents with cough, fever and leukocytosis
The CT reveals a peripheral subsegmental consolidation in the posterior segment of the LUL with cavitation Biopsy and cultures confirmed bacterial abscess
Ashley Davidoff MD TheCommonVein.net 261Lu 118359

Aspergilloma

Aspergilloma – CT Air Crescent Sign Changing Position with Patient Positioning
CT scan in the axial projection with the patient in the supine position shows a soft tissue mass in the right upper lung field with an anterior crescent shaped rim of air (blue arrowheads) anterior to the aspergillus fungus ball (a, magnified in b) 
Since the fungus ball is movable, when the patient is placed in the the left decubitus position c and d), the  fungus ball “sinks” to the dependent position and the air moves to the most superior position (blue arrowheads)
Ashley Davidoff TheCommonVein.net 78612a L

 

Inflammation

WEGENER”S GRANULOMATOSIS aka GRANULOMATOSIS WITH POLYANGIITIS, GPA
54 year old female presented with painless persistent dry cough, loss of appetite, weight loss, and worsening renal function. Urinary sediment showed white cells suggestive of glomerulonephritis. ANCA test and ANA were negative, ANA negative. Vasculitis was suspected and she was started on solumedrol and cyclophosphamide which improved her symptoms.
She had an uneventful renal biopsy.
The scout film (a) shows two mass like lesions in the left mid and upper lung zones,(white arrowheads) with coronal (b) imaging showing a nodule (black arrowhead) and a mass (red arrowhead) also in the mid and upper left lung. Image c in sagittal projection shows a large mass in the superior segment of the LUL and a second in the anterior segment of the LUL both both with air bronchograms(teal arrowheads). For the large mass like lesions, subacute hemorrhage is a radiological consideration and for the smaller nodules granulomatous nodules of Wgeners seems to be more likely.
Ashley Davidoff MD

Benign Hamartoma Non Calcified

33 year old male with a mildly heterogeneous soft tissue nodule in the left upper lobe showing no growth and representing a hamartoma
Ashley Davidoff MD TheCommonVein.net benign hamartoma 004 33m

Speckled Calcification

79 year old male with a 5.5cms mass in the left upper lobe shown on CT coronal reformats (upper) and axial projection (lower) on bone and soft tissue windows. The mass is characterized by heterogeneous “popcorn-like” calcifications Findings are consistent with a hamartoma
Ashley Davidoff MD TheCommonVein.net hamartoma 003c

Popcorn Calcifications

86 year old female with a stable calcified nodule in the right lower lobe. The calcification is lobulated and this appearance is reminiscent either of the popcorn calcification of a hamartoma or an amyloid nodule
Ashley Davidoff TheCommonvein.net
hamartoma 0001c01 86f

Heavy Homogeneous Calcification – Hamartoma

80 year old male with stable calcifications in a 2.9cms lung nodule. The calcification is large and irregular and mostly central. Diagnosis includes a benign hamartoma
and amyloidoma
Ashley Davidoff TheCommonvein.net
hamartoma calcifications 004c stable

Metastases

Calcified Metastases in the Lung from Leiomyosarcoma of the Uterus
CT scan through right lower lobe of the lung shows a calcified mass representing a metastasis from a primary uterine leiomyosarcoma.
Ashley Davidoff MD TheCommonVein.net 135680

Castleman’s Disease

Non Contrast CT
The non-contrast CT of the right lower lobe lung mass shows homogeneous soft tissue density .  Pathology showed Castleman’s disease 
Courtesy Priscilla Slanetz MD MPH
TheCommonVein.net
Contrast Enhanced CT
The contrast enhanced  CT of the right lower lobe lung mass in the right lower lobe .  I mage a, magnified in b shows mostly homogeneous enhancement with a suggestion of nodular morphology  .  Image c shows a region anteriorly with slightly greater enhancement , and magnified in d.
Pathology showed Castleman’s disease 
Courtesy Priscilla Slanetz MD MPH
TheCommonVein.net

Cancer 

Adenocarcinoma

53 year old male with history of smoking presents with a cough Axial CT scan with lung windows shows the mass with surrounding ground glass changes with thickening of interlobular septa and thickening of adjacent airways reminiscent of lymphangitis
Diagnosis – adenocarcinoma of the lung with extensive necrosis of the tumor
Ashley Davidoff MD The CommonVein.net
53 year old male with history of smoking presents with a cough Axial CT scan with soft tissue windows shows a 8.5 cm mass in the left upper lobe
Diagnosis – adenocarcinoma of the lung with extensive necrosis of the tumor
Ashley Davidoff MD The CommonVein.net

Congenital Growth Abnormalities

CT shows a Lobulated Complex, Predominantly Low Density Mass withvVenous Drainage into the Right Lower Lobe Pulmonary Vein
Ashley Davidoff MD TheCommonVein.net  intralobar sequestration 008
CT shows a Lobulated Complex, Predominantly Low Density Mass withvVenous Drainage into the Right Lower Lobe Pulmonary Vein
Ashley Davidoff MD TheCommonVein.net  intralobar sequestration 007
Intralobar Sequestration in a patient who presents with a chronic cough bloody sputum and a mass/consolidation on CXR in the right lower lobe
Ashley Davidoff MD
TheCommonVein.net  intralobar sequestration 001

Pulmonary Hemorrhage Hematoma Fissural Displacement Ground Glass Changes

Pulmonary Hemorrhage Hematoma Fissural Displacement Ground Glass Changes
75-year-old man on blood thinners s/p aortic valve replacement, s/p trauma, presents with hemoptysis. He was afebrile and without an elevated white count
Coronal CT of the posterior lung fields shows inferior displacement of the major fissure by a dense right upper lobe consolidation. The mass effect on the major fissure likely results from a hematoma. Lateral to the consolidation there is a combination of ground glass opacity. There is elevation of the right hemidiaphragm. Left sided pleural effusion is present
Ashley Davidoff MD TheCommonVein.net 165Lu 135860