Hampton humps: on MRI

Case contributed by Roberto Schubert
Diagnosis almost certain

Presentation

During a hospital stay for hemoptyses, bronchoscopy was normal and CTPA reportedly excluded pulmonary embolism. However a peripheral "consolidation" was seen in the left lower lobe, and MRI was recommended to rule out a neoplasm.

Patient Data

Age: 80
Gender: Female
mri

Compared with the above mentioned report from a CTPA performed 3 weeks earlier, pleural effusion has developed in the left costophrenic angle. There are two subpleural opacities in the left lower lobe, that hadn't resolved.

Case Discussion

Together with the clinical signs and symptoms, the findings are indicative of peripheral pulmonary embolism with infarct pneumonia. Ideally, the presence or absence of pulmonary embolism should be determined with sufficient certainty by CTPA without the need for additional imaging tests.

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