PMC7708850_01
(A) Chest radiograph, performed 8 days after EBUS-TBNA, shows pleural effusion in both lungs, enlarged heart margin, and the size of the shadow previously observed in right hilar region increased further; (B, C) chest CT, performed 8 days after EBUS-TBNA, shows large amount of pericardial effusion, enlargement of the right lower paratracheal lymph nodes, and a multiloculated mediastinal abscess with gas formation along with the appearance of pleural effusion in both lungs.
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On a chest X-ray, pleural effusion of both lung fields and enlarged heart margin were revealed, in addition to a previously observed shadow in the right hilar area that had increased in size (Fig. 1A). On a chest CT, enlargement of the right lower paratracheal lymph nodes and a multiloculated mediastinal abscess with gas formation (Fig. 1B, C) were observed.
PMC7708850_02
(A, B) Chest CT, performed 21 days after EBUS-TBNA, shows enlargement of the lymph node accompanied by the intranodal necrotic portion; (C) chest CT, performed 5 days after operation, shows loculated effusion with newly generated gas formation.
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On chest CT scan, enlargement of the lymph node accompanied by the intranodal necrotic portion was found (Fig. 2A, B). A loculated effusion with newly generated gas formation was observed, and empyema was suspected; therefore, the patient underwent a reoperation (Fig. 2C).