PMC10200706_01
Anteroposterior chest radiograph: bilateral, ground-glass opacities in
the mid, and lower zone.
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Anteroposterior chest radiograph showed bilateral ground-glass opacities in the mid and lower zones (Figure 1).
Thorax CT scan. (A) (at admission): diffuse consolidation in the
subpleural areas of the upper, middle and lower lobes with ground glass
opacities associated with bronchiectasis and mild emphysema, (B)
(2 weeks later): widespread ground-glass opacities and consolidation
areas in both lungs, (C) (2 months later): ground-glass opacities
progression leading to 100% lung involvement, subpleural reticular
pattern, cavitary lesions, thin-walled with several septum-like
structures inside in right upper, and lower lobe.
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Nonenhanced thorax CT scan revealed isolated consolidation areas in the upper (left > right) and lower lobes, diffuse, predominantly subpleural, consolidation in the lower lobes associated with bronchiectasis, and mild, diffuse, bilateral centrilobular, and subpleural emphysema, as well as nonspecific enlargement of upper and middle mediastinal lymph nodes (Figure 2A). A new contrast enhanced thorax CT scan was performed on the 15th day, which revealed widespread ground-glass opacities and consolidation areas in both lungs, involving 70% of lung parenchyma (Figure 2B), as well as nonocclusive blood clots in various segmental arteries in both lungs and enlarged mediastinal lymph nodes. Unfortunately, contrast enhanced thorax CT scan performed about 2 months after admission (22.12) showed ground-glass opacities progression encompassing the entire lung parenchyma and thin-walled cavitary lesions with septum-like structures inside in the right upper and lower lobes (the largest 2 having transaxial diameters of 86/58 mm and 37/34 mm), besides emphysematous spaces, bronchiectasis, pulmonary fibrosis, and persistent nonspecific enlarged mediastinal lymph nodes (Figure 2C).
Thorax CT scan: massive right pneumothorax associated with complete right
lung collapse, displacement the mediastinum and compression the left
lung.
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The contrast enhanced thorax CT scan (04.01) demonstrated massive right pneumothorax inducing complete right lung collapse, left displacement of the mediastinum, and left lung compression (Figure 3).
Anteroposterior chest radiograph: lung reexpansion with small right-sided
apical pneumothorax and diffuse ground-glass opacity.
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Chest radiograph performed 2 days later (06.01) demonstrated almost complete right lung reexpansion with only a small residual apical pneumothorax (Figure 4).