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Secondary pulmonary lobules outlined by aspiration

Case contributed by RMH Core Conditions
Diagnosis not applicable

Presentation

MVA high-speed into tree with LOC and multiple injuries.

Patient Data

Age: 25 years
Gender: Female

Centrilobular ground glass opacity most prominent within the right middle lobe but present also in the upper & lower lobes & in the left lower lobe. In addition patchy peripheral opacity is seen especially on the right in the middle lobe. The pattern suggests endobronchial process & is seen in hypersensitivity pneumonitis & aspiration & endobronchial infection. In the current setting, it is likely to be due to aspiration, especially as debris is noted in the trachea. 

Conventional aortic arch anatomy. No traumatic aortic injury. No pneumothorax. No pleural or pericardial effusion. 

No axillary or mediastinal lymphadenopathy. No rib fracture seen. A 15mm soft tissue nodule is identified in the left parahilar region projecting into and deforming the left lower bronchus distal to the origin of the superior segmental bronchus and at the level of its division into the basal segmental bronchi.

Differential diagnosis includes carcinoid tumor and lymphadenopathy.

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