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Clinical presentation:
22 year old man with pyrexia, dyspnoea and cyanosis. A worried ITU. consultant requested pulmonary angiography, which gave us this nice example of physiology.

There is density in the right lower zone with loss of silhouette of the diaphragm, right heart margin and the basal vessels in the right lower lobe. The visible upper horizontal margin marks a pleural boundary, but is not the highest point of the affected lung. There is a visible air-bronchogram.

Of particular interest in this case is the angiogram showing diversion of blood away from the abnormal lobe in a bid to maintain normal oxygen tension in the systemic circulation.

[pneumonia] [vascular changes]


[Differential]

cases that might resemble this pathology

[View large image] Aspiration misplaced NG tube (case report) [View large image] Pulmonary oedema, altered by underlying lung disease COPD. (case report)
[View large image] Pulmonary infarct (case report) [View large image] Sickle cell crisis (case report)
[View large image] Pulmonary contusion (case report) [View large image] interlobar effusion (case report)
[View large image] Fibrosing Alveolitis (case report) [View large image] Lymphoma (case report)
[View large image] Alveolar cell carcinoma (case report) [View large image] Hydrocarbon pneumonia (case report)
[View large image] sub-phrenic abcess (case report)
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[London South Bank U.]

IDM April 2006