CXR with Cavitation in the Left Lung Apex and Lingula Infiltrate

46 year old immunocompromised male presents with a fever. CXR shows a cavitating nodule in the left apex and a lingula infiltrate partially silhouetting the left heart border.
Ashley Davidoff TheCommonVein.net
CXR with Lingula Infiltrate

46 year old immunocompromised male presents with a fever. Lateral CXR shows a lingula infiltrate, partially silhouetting the left heart border better seen in the magnified view.
Ashley Davidoff TheCommonVein.net
CT with Cavitation in the Left Lung Apex and Lingula Infiltrate

46 year old immunocompromised male presents with a fever. Scout for the CT scan shows a cavitating nodule in the left apex and a lingula infiltrate partially silhouetting the left heart border.
Ashley Davidoff TheCommonVein.net
CT shows Small Air Bubble in Right Apex and Calcification in a Nodule in the Left Apex ? Colonized Aspergillomas in TB Cavities Probable Chronic Pulmonary Aspergillosis

Ashley Davidoff TheCommonVein.net
CT – Large Biapical Cavities Likely TB in origin with Colonized Aspergillomas

46 year old immunocompromised male with a fever. CT shows small biapical cavitations with internal solid debris .
Diagnosis probable Chronic Pulmonary Aspergillosis with Aspergillomas in TB cavities
Ashley Davidoff TheCommonVein.net
CT with Lingula Infiltrate

46 year old immunocompromised male presents with a fever. Axial CT shows a subsegmental lingula infiltrate, abutting and silhouetting the left heart border
Ashley Davidoff TheCommonVein.net
Discussion
The case without further clinical history
The aspergillus infection diagnosis was presumably made on the basis of sputum and serological testing. There is no obtainable history regarding tuberculosis. However the presence of biapical disease and calcifications in the left apex, raises the suspicion of colonization of TB cavities and hence the diagnosis of chronic pulmonary aspergillosis seems likely. The pneumonia in the lingula is likely an unrelated problem, possibly secondary to immunocompromise .
-
TCV Links