PMC4681968_01
Chest X-ray showing right hydro pneumothorax.
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One month back the patient had been evaluated for the above complaints and a diagnosis of right sided tubercular empyema (Fig. 1) was made, for which a chest tube drain was inserted and was prescribed anti tubercular treatment.
CT showing collapse consolidation in right lower lobe with cavitation in the apical segment.
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A Computed Tomography (CT) of the chest done subsequently showed a large area of consolidation in the apical segment of right lower lobe (Fig. 2).
A saccular aneurysm in the right lower lobar pulmonary artery.
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Subsequently Computed Tomography Pulmonary Angiography (CTPA) was done which revealed a saccular aneurysm involving the distal part of right lower lobar pulmonary artery measuring 3.1 x 2.3 cm with a neck diameter of 4.2 mm suggestive of Pulmonary Artery Aneurysm (PAA) (Fig. 3).
H & E stained section showing sparsely septate irregular obtuse fungal hyphae (broken arrows) in a necrotic background (solid arrows). X10X.
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Meanwhile, the HPE report of the lobectomised lung tissue was reported as invasive mucormycosis (Fig. 4) which was sensitive to amphotericin.