CTICasesAsymmetric Pulmonary Edema with Septal and Lymphatic Congestion Mimicking Infection
[...]. Asymmetric Pulmonary Edema with Septal and Lymphatic Congestion Mimicking Infection. CTICases. Published August 20, 2018. https://str-case-explorer.pages.dev/c/tp86x
Imaging findings
The same patient later returned neutropenic and febrile with a nonspecific area of right-upper-lobe consolidation that, over just six days, rapidly evolved into extensive lobar consolidation with bilateral small effusions and prominent interlobular septal thickening described as venous lakes and lymphatic pearls. Bronchoscopy grew Aspergillus, but the pulmonary veins were patent and uncompromised, and the abnormality improved substantially within about a week on antifungals and diuresis.
Key takeaways
Rapidly evolving lobar consolidation with septal thickening and small effusions in a neutropenic patient can reflect asymmetric pulmonary edema and lymphatic congestion, from adjacent inflammation obstructing lymphatics, rather than pure progressive infection, particularly when the pulmonary veins are patent and the abnormality resolves rapidly with diuresis. A positive culture such as Aspergillus does not preclude a coexisting vascular or lymphatic congestive component driving much of the imaging appearance.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Acute Aortic Syndrome (Intramural Hematoma) with Intercostal Artery PseudoaneurysmsAorta & Arteries
- Pleural and Nodal Large B-Cell LymphomaNeoplastic
- Incidental Ectopic Ossific Lesion ("Rocks of Bone") of Unknown EtiologyArtifact
- High-Altitude Pulmonary EdemaExposure
- Pneumomediastinum from Macklin Phenomenon (Football Chest Trauma)Trauma
- Central Venous Catheter Malposition into an Azygos Vein within an Azygos LobeIatrogenic
- Systemic Arterial Supply to the Left Lower Lobe with Atrial Septal DefectCongenital
- Left Isomerism (Polysplenia Syndrome) with Azygos Continuation of an Interrupted IVCCongenital
See all cases from August 20, 2018 →
Related Vascular cases
- Acute Pulmonary Embolism with Pulmonary Hemorrhage
- Pulmonary Artery Pseudoaneurysm After Chemoradiation for Lung Cancer
- Chronic Non-Recanalized Pulmonary Embolism with Hemorrhagic Infarction
- Chronic Thromboembolic Pulmonary Hypertension with Central Organized Clot
- Bronchial Artery Aneurysm in Longstanding Bronchiectasis
- Asymmetric Pulmonary Edema from Eccentric Mitral Regurgitation