Friday, September 09, 2005

Abnormal CxR

This patient has no pulmonary symptoms. He had cxr because of severe GERD-related issues. Here is his CXR:

His CT is shown here:
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Here is the CT reconstruction:
What is the abnormality and what's your differential. Dont worry about guessing way off base, just guess!

4 comments - CLICK HERE to read & add your own!:

Mendez said...

The prominent vessel on CT and the reconstruction image suggests pulmonary sequestrum. Usually parenchyma in this "accessory lung" is quite abnormal, cystic and bronchiectatic. I don't know if this is seen in other cuts b/c it's not obvious in the ones you've shown.

Baleeiro said...

The abnormality on the CT and the CxR looks more like a hollow viscus (e.g. small bowel) in the thorax. The extra vessel seems to originate from the aorta almost below the diaphragm. It seems like a congenital hernia or a congenital cystic adenomatoid malformation (which will be more "hollow" than bronchopulmonary sequestration) rather than a lung sequestration...

Arenberg said...

When I saw the CXR and CT images I was thinking of an AVM or sequestration, but the 3-D images of the CT are beautiful, and demonstrate a sequestration. Nice pictures Jeff!

Jennings said...

See follow-up above. Yeah this reconstruciton is cool because you can see the arterial supply AND the venous drainage back to the atrium.