There is a left axillary node measuring 2.4 cm in long axis. Multiple enlarged right axillary lymph nodes. No convincing lymphadenopathy identified within the mediastinum.
Note is made of a retro oesophageal course of the right subclavian artery with mild mass effect upon the oesophagus.
There is collapse with loss of volume seen at the left lower lobe. Some of the collapsed lung demonstrates heterogeneous enhancement. There is a small left-sided pleural effusion. Atelectasis at the right lung base. Subpleural nodule associated with the minor fissure.
There are two lung cysts seen within the posterior aspect of the right upper lobe potentially related to previous infection - with lymphocytic interstitial pneumonitis thought less likely though not excluded given the immunological predisposition.The central airways are unremarkable.
No pericardial effusion.
Review of the imaged upper solid organs demonstrates an enlarged spleen with multiple peripheral regions of low density. The likely aetiology is multiple splenic infarcts.
Conclusion:
The changes at the left lung base may be sympathetic related to the subdiaphragmatic splenic infarcts with superimposed infection not excluded.