PMC6609725_01
Chest X-Ray AP and Lateral view showing right mid-zone mass lesion.
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Chest X-ray showed an opacity in the right mid-zone (Fig. 1a). There was no endoluminal bronchial lesion nor mediastinal or hilar lymph node enlargement. (Fig. 1b).
CT chest image showing mass in right lower lobe.
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Due to the high index of suspicion of lung malignancy, a PET-CT was performed, which demonstrated mild to moderate FDG avidity of the mass in the right lower lobe (Fig. 2a) but no other FDG avid nodal or distant metastatic disease. The EBUS images (Fig. 2b) demonstrated a heterogeneous lesion with non-compressed blood vessels and scattered air space shadows.
PET CT - FDG avidity shown in right lower lobe mass.
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Bacterial culture from bronchial brushings was subsequently confirmed as Burkholderia pseudomallei, making the diagnosis of pulmonary melioidosis (Fig. 3).