EURORAD ESR

Case 10069

Haemoptysis in an immunocompromised patient with angioinvasive pulmonary aspergillosis and associated mycotic aneurysm of left subclavian artery

Author(s)
Thakral A, Chaturvedi A, Avinash Rao S, Garg M

Rajiv Gandhi Cancer Institute & Research Centre,
Rohini, New Delhi - 110085;
Email:thakral_anuj@yahoo.com
 
Patient
male, 66 year(s)
 
 
  • Figure 1
    Parenchymal nodular lesions in initial CECT chest

    Parenchymal nodular lesions in initial CECT chest.

     
    Area of Interest: Thorax; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Infection;
     
     
  • Figure 2
    CT halo sign in initial CECT chest

    Nodular lesions with surrounding ground-glass attenuation - CT halo sign.

     
    Area of Interest: Thorax; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Haemorrhage;
     
     
  • Figure 3
    CECT chest post haemoptysis (1 month after initial study)

    Lung lesions with invasion of left subclavian artery showing irregular walls.

     
    Area of Interest: Thorax; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Dilatation;
     
     
  • Figure 4
    CECT chest post haemoptysis (1 month after initial study)

    Cavitating lesions in both lungs.

     
    Area of Interest: Thorax; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Cavitation;
     
     
  • Figure 5
    CECT chest post haemoptysis (1 month after initial study), lung window

    Cavitating lesions with air crescent sign in both lungs.

     
    Area of Interest: Thorax; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Cavitation;
     
     
  • Figure 6
    CECT chest post haemoptysis, lung window in lateral decubitus position

    Change in position of necrotic lung tissue with decubitus position.

     
    Area of Interest: Thorax; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Cavitation;
     
     
  • Figure 7
    CECT angiography sagittal MIP image

    Left subclavian artery pseudoaneurysm abutting left upper lobe cavitary lesion.

     
    Area of Interest: Thorax; Imaging Technique: CT-Angiography; Procedure: Contrast agent-intravenous; Special Focus: Aneurysms;
     
     
  • Figure 8
    CECT angiography axial MIP image

    Left subclavian artery pseudoaneurysm surrounded by left upper lobe lesion.

     
    Area of Interest: Thorax; Imaging Technique: CT-Angiography; Procedure: Contrast agent-intravenous; Special Focus: Aneurysms;
     
     
  • Figure 9
    KOH preparation from bronchscopic lavage done next day

    KOH preparation from bronchscopic lavage showing septate fungal hyphae (magnification: 400x).

     
    Area of Interest: Thorax; Imaging Technique: CT; Procedure: Laboratory tests; Special Focus: Infection;
     
     
Parenchymal nodular lesions in initial CECT chest.
 
Nodular lesions with surrounding ground-glass attenuation - CT halo sign.
 
Lung lesions with invasion of left subclavian artery showing irregular walls.
 
Cavitating lesions in both lungs.
 
Cavitating lesions with air crescent sign in both lungs.
 
Change in position of necrotic lung tissue with decubitus position.
 
Left subclavian artery pseudoaneurysm abutting left upper lobe cavitary lesion.
 
Left subclavian artery pseudoaneurysm surrounded by left upper lobe lesion.
 
KOH preparation from bronchscopic lavage showing septate fungal hyphae (magnification: 400x).
 
 
 
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