PMC7369350_01
Chest X-ray PA view revealed non-homogenous radio dense opacity in left upper and midzone.
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Chest radiograph PA view (Fig. 1) revealed non homogenous opacity left upper and mid-zone.
Chest CT showed heterogeneously enhancing lesion measuring 6.4 x 6.8 x 5.6cm with internal areas of necrosis and surrounding ground glass attenuation in apico-posterior segment of left upper lobe with partial occlusion of left apicoposterior segmental bronchus.
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CECT chest (Fig. 2A and B) was suggestive of heterogeneously enhancing lesion measuring 6.4 x 6.8 x 5.6cm with internal areas of necrosis and surrounding ground glass attenuation in apico-posterior segment of left upper lobe with narrowing and partial occlusion of left apicoposterior segmental bronchus with few enlarged intrapulmonary lymphnodes.
Bronchoscopic findings revealed soft tissue endoluminal lesion completely occluding left upper lobe segments.
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Videobroncoscope showed soft tissue endoluminal lesion completely occluding left upper lobe segments which bleeds on biopsy (Fig. 3).
Endobronchial biopsy was suggestive of capillaritis with leucocytoclasis and infiltration by both acute and chronic inflammatory cells and occasional multinucleated giant cells.
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On histopathology (Fig. 4A and B) endobronchial biopsy was suggestive of capillaritis with leucocytoclasis and infiltration by both acute and chronic inflammatory cells and occasional multinucleated giant cells.
Follow-up chest X-ray PA view suggestive of complete radiological clearance after one week of steroid therapy.
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Chest x-ray (Fig. 5) after one week of therapy showed significant clearance of left upper zone lesion along with clinical improvement with amelioration of breathlessness and haemoptysis.