PMC9512125_01
Chest X-ray. A. The first presentation in hospital - 5 months prior to current presentation - rare irregular opacities in right and left lung and interstitial pattern. B. Current presentation - Disseminated right and left lung irregular opacities with a tendency to confluence.
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The chest X-ray five months ago described irregular opacities in both right and left lungs, accentuated interstitial sketch and cardiomegaly (Figure 1A), while four months later, the chest X-ray showed areas of irregular opacities in right and left lungs, with other localization, and cardiomegaly.
The first presentation in hospital - 5 months prior to current presentation - CT examination - areas of dense ground glass opacity in posterior segment of upper right lobe, postero-lateral medium lobe and apical of inferior right lobe segment; smaller ground glass area in apico-posterior of left upper lobe and anterior basal segments were noted.
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CT images from one month ago showed right and left small areas of alveolar filling, in posterior segment and anterior segment of left upper lobe, different as location to five months ago CT examination, which showed areas of dense ground glass opacity in posterior of upper right lobe, postero-lateral of medium lobe and apical of inferior right lobe segments; in the left lung this areas were smaller and in apico-posterior and anterior basal segments; air-trapping elements and mosaic of pulmonary ventilation (Figure 2).
Increased hepatic attenuation at first and second CT examination.
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Increased hepatic attenuation (Figure 3) and a thyroid nodule in the right lobe (Figure 4) were noted in both examinations.
Thyroid nodule in right lobe at first and second CT examination.
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Increased hepatic attenuation (Figure 3) and a thyroid nodule in the right lobe (Figure 4) were noted in both examinations.
Current presentation - CT scan - In upper lobes asymmetric centrilobular nodules and dense ground glass opacities and also another asymmetrical areas of dense ground glass opacities with few consolidation in lower lobes.
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Chest computed tomography (CT) scan on day 4 of presentation showed in upper lobes asymmetric centrilobular nodules and areas of dense ground glass opacity and also asymmetrical areas of dense ground glass opacity with few consolidation (Figure 5); cardiomegaly without pericardial effusion.
Current presentation - Diffuse increase in attenuation of liver.
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A diffuse increase in hepatic attenuation, with 90 Hounsfield units was observed on CT scan images, consistent with iodine deposition from amiodarone (Figure 6).
Current presentation - Lobulated heterogeneous thyroid gland.
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Also a heterogeneous thyroid gland was noted (Figure 7).
Chest X-ray - Slowly interstitial accentuated pulmonary sketch.
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Findings on chest X-ray take time to resolve and in our case in three months follow up were near normal (Figure 8).