PMC4900986_01
38-year-old male with metastatic choriocarcinoma. A. Coned-down transverse CT image of the lung demonstrates lucent halos surrounding numerous nodules, predominantly seen in the right lower lobe, indicating pulmonary interstitial emphysema. B. A perivascular lucency can also be seen adjacent to a right lower lobe bronchus, also indicating the presence of interstitial gas.
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The CT examination again demonstrated numerous metastatic pulmonary nodules as well as the airspace and interstitial opacities concerning for infection (Fig. 1). In addition, there were very subtle areas of perivascular lucencies (Fig. 1).
38-year-old male with metastatic choriocarcinoma. Transverse CT image from a CT pulmonary angiogram obtained 9 days prior. Again demonstrated are the numerous pulmonary nodules of metastatic choriocarcinoma. However, the lucent halos are absent. Also seen is the large right pleural effusion for which a chest tube was placed, leading to the initial, trace pneumothorax.
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However, these findings had not significantly changed since a CT pulmonary angiogram obtained nine days before (Fig. 2).
38-year-old male with metastatic choriocarcinoma. A. Transverse CT images of the chest and mediastinum obtained seven days later demonstrate interval development of severe pneumomediastinum and massive subcutaneous emphysema. B. The subcutaneous emphysema has dissected inferior into the inguinal canals and scrotum.
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A CT examination performed one week later demonstrated severe subcutaneous emphysema, pneumomediastinum, and pneumoperitoneum (Fig. 3).