Discussion of interesting or befuddling cases related to pulmonary and critical care medicine.
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...
1 comments - CLICK HERE to read & add your own!:
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...
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