PMC6831836_01
Chest X-ray on admission: right upper lobe airspace disease and consolidation.
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His portable chest x-ray on admission showed a large right upper lobe (RUL) opacity (Fig. 1).
Computed tomography pulmonary angiography protocol. Cystic and cavitary changes with ground glass opacities in the right upper lobe consistent with necrotizing pneumonia and hemorrhage. The esophagus is dilated secondary to the partially obstructing esophageal cancer.
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Computed tomography demonstrated a cavitating RUL mass and extensive ground glass opacities suggestive of a necrotizing pneumonia (Fig. 2) and an intraluminal filling defect in the distal right main pulmonary artery consistent with a PE (Fig. 3).
Bronchial artery embolization of right upper lobe. Left: extravasation of contrast from a branch of the bronchial artery prior to embolization. Right: successful embolization of the culprit artery.
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Two arterial sources of bleeding were identified to be directly related to the cavitary RUL mass; an arterial branch arising from a right intercostal artery as well as a branch of the right bronchial artery (Fig. 4).