Presentation
Shortness of breath, evaluate for pulmonary embolism.
Patient Data
There is a partially cavitary, partially calcified mass in the right upper lung lobe apical segment with extension to the lateral and posterior periphery. There is adjacent pleural thickening/reaction. There is a similar left upper lung lobe small posterior lesion with possible cavitation. There is severe upper lobe predominant emphysema (mainly centrilobular and paraseptal). No diffuse pattern of pulmonary nodularity was detected to suggest metastasis. There are scattered calcified lymph nodes and hilar calcifications.
Case Discussion
This is a case of pulmonary tuberculosis.
The patient was a chronic tobacco user so the initial concern was a cavitating lung malignancy. The patient was referred to interventional radiology who performed a lung biopsy. Pathology analysis was consistent with tuberculosis, without evidence of malignancy. The patient was subsequently referred to infectious disease for further management.
Co-authors:
Christopher Talone
Camille Dumas, DO
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