PMC7533101_01
A 65-year-old man with diffuse large B-cell lymphoma of the liver who presented with failure to thrive and received inpatient chemotherapy. (a) Chest computer tomography (CT) lung window (1.5 mm thickness axial reconstructed image) from hospital day 1 showing unremarkable lung parenchyma; (b) CT abdomen lower lung window (3 mm thickness axial reconstructed image) from hospital day 17 demonstrating a 7.3 cm thick-walled cavitary lesion in the left lower lobe; (c) chest CT lung window (1.5 mm thickness axial reconstructed image) from hospital day 18 showing an air- fluid level within the thick-walled left lower lobe cavitary lesion; (d) CT pulmonary angiogram (1.5 mm thickness axial reconstructed image) from hospital day 24 with arrow showing a 1.9 x 1.5 cm saccular contrast-enhancing lesion in the left lower lobe posterior basal segment.
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F1
CT of the abdomen and pelvis performed during hospital day 17 to evaluate for small bowel obstruction incidentally revealed a thick-walled cavitary lesion in the left lower lobe, which was not present on chest CT obtained at the time of admission [Figure 1, Panels a and b]. Subsequent non-contrast-enhanced chest CT performed before the patient's cardiac arrest revealed a new air fluid level within the cavitary lesion [Figure 1, Panel c]. CT pulmonary angiography demonstrated a 1.9 x 1.5 cm saccular contrast- enhancing lesion in the left lower lobe posterior basal segment, medial to the previously noted left lower lobe cavitary lesion [Figure 1, Panel d].
A 65-year-old man with diffuse large B-cell lymphoma of the liver who presented with failure to thrive and received inpatient chemotherapy. Bronchoalveolar lavage specimen demonstrating broad thin-walled non-septate hyphae.
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F2
Cytologic findings from the bronchoalveolar lavage were consistent with Mucor and the patient was diagnosed with PAP secondary to PM [Figure 2].
A 65-year-old man with diffuse large B-cell lymphoma of the liver who presented with failure to thrive and received inpatient chemotherapy. (a) Computed tomography pulmonary angiogram (3 mm thickness coronal reconstructed image) showing the left inferior pulmonary artery pseudoaneurysm; (b) digital subtraction angiogram from a selectively catheterized left inferior pulmonary artery demonstrating the pseudoaneurysm; (c) post embolization digital subtraction angiogram demonstrating no flow to the inferior pulmonary artery pseudoaneurysm.
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F3
He was treated with isavuconazonium for his underlying PM and underwent successful embolization of the PAP [Figure 3].