PMC6480994_01
CT scan of the chest showing bilateral hilar and mediastinal lymph-adenopathy (white arrows), focal areas of increased interstitial thickening scattered throughout both lungs, bilateral pleural effusions, prominence of the interlobular septa (black arrows), and the absence of pulmonary embolism.
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Computed tomography (CT) pulmonary angiogram was negative for pulmonary embolism (PE) but showed ground glass opacities, hilar and mediastinal lymphadenopathy, bilateral pleural effusions, and increased prominence of the interlobular septa (Figure 1).
V/Q scan showing high probability for PE. Innumerable small sized peripheral and non-peripheral perfusion defects scattered throughout the entirety of bilateral lungs. Several perfusion/ventilation mismatch areas are seen.
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Ventilation/perfusion lung scan (V/Q scan) showed perfusion defects scattered throughout the entirety of bilateral lungs with several areas of perfusion/ventilation mismatch (Figure 2), which raised the suspicion of CTEPH, and patient was started on heparin infusion.