PMC9483779_01
Radiological findings on admission. A. Chest radiography showing a left hilar protruding shadow (arrowhead). B. Chest computed tomography (CT) indicating thick-walled lesions with cavities in the left upper lung (arrowhead). C-D. Contrast-enhanced CT of the chest revealing thrombosis in bilateral pulmonary arteries (arrowheads) and left hilar lymphadenopathy (arrows). E. Head CT (sagittal view) demonstrating high-density lesions in the superior sagittal and straight sinus (arrowheads). F. Magnetic resonance venography (MRV) of the brain. Loss of venous signals is seen in the superior sagittal, transverse, and sigmoid sinus (arrows), suggestive of acute thrombosis.
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Chest radiography revealed a protruding shadow in the left hilum (Fig. 1A). Chest computed tomography (CT) revealed thick-walled cavitating lesions in the upper left lung (Fig. 1B). Contrast-enhanced CT revealed thromboses in the bilateral pulmonary arteries and lymphadenopathy in the left hilum (Fig. 1C-D). CT or Doppler ultrasonography. CT of the head revealed high-density lesions in the superior sagittal, straight, and sigmoid sinuses (Fig. 1E). Magnetic resonance venography (MRV) showed loss of signals in the superior sagittal, transverse, and sigmoid sinuses (Fig. 1F).
Radiological findings at follow-up. A-B. Contrast-enhanced CT of the chest three weeks after the admission. Note that marked amelioration of thromboses in bilateral pulmonary arteries (arrowheads). C. Chest radiography after completion of anti-tuberculous therapy showing shrinkage of the left hilar lymphadenopathy. D. MRV after completion of edoxaban therapy indicating recovery of the venous blood flow in the right cerebral venous sinuses (arrows).
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After three weeks of admission, a followed-up CT scan revealed the amelioration of the cerebral sinus thrombosis (not shown) and bilateral pulmonary thromboembolism (Fig. 2A-B). After the completion of the treatment, a follow-up chest radiography showed shrinkage of the left hilar lymphadenopathy, and MRV of the brain indicated recovery of the venous blood flow in the cerebral sinuses (Fig. 2C-D).