PMC9715317_01
Chest X-ray. AP projection. Consolidation expanded the right upper lobe, with a mildly bulging horizontal fissure and a thin white arrow. Several small foci of cavitation exist within the consolidated RUL, one of which is indicated by the thick black arrow. Bilateral lower zone ground-glass opacities, thin black arrow on the left.
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fig1
His admission chest X-ray (Figure 1) demonstrates dense consolidation in the right upper lobe.
(a) Axial contrast enhanced CT image with mediastinal window settings demonstrating consolidated RUL (thick black arrow) with foci of cavitation, one of which is indicated with the thin black arrow. Mildly enlarged pretracheal-retrocaval lymph node (thin white arrow). (b) Contrast-enhanced CT reconstruction through the right hemithorax with mediastinal window settings. Expanded, consolidated RUL with depression of the oblique fissure indicated by a thin white arrow. Collapsed RML demonstrating enhancement, contrasting with the hypo-enhancing consolidated RUL (thin black arrow). Small right pleural effusion (thick white arrow). (c) Axial CT image with lung window settings demonstrating bilateral multilobar foci of ground-glass density (thin black arrows) and a focus of RLL paravertebral subpleural consolidation (thick black arrow).
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fig2
A computed tomography pulmonary angiogram (CTPA) was taken to rule out pulmonary embolus (PE), the image quality was heavily affected by the other ongoing pathologies but did not demonstrate any embolus (Figure 2), instead confirming the X-ray findings, although notably now bilateral ground-glass opacities and consolidation and a small amount of right-sided pleural effusion.