Wednesday, October 11, 2006

What is wrong with this picture?

This 26 y/o man with a history of smoking 1 ppd cae to the ER with cough and new hemoptysis.

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

Anonymous said...

First, it looks like there is volume loss with shift of the mediastinal structures to the right.

On the CT scan I do not see a right pulmonary artery and the pulmonary trunk looks awefully enlarged. It's difficult to tell, but it looks like there is calcification in the medistinal lymph nodes: subcarinal and possibly right hilar.

So--In this young man, I'd suspect a granulomatous disease-possibly histo with fibrosing mediastinitis. The hemoptysis could be from a broncholith or pulmonary hypertension...