IS Case 287: Pulmonary infarction

Nadia F. Yusaf, MD


Imaging Sciences URMC 2009
Publication Date: 2009-08-05

History

A 36-year-old female presented to the Emergency Department with shortness of breath and chest pain.

Findings

Chest x-ray showed prominence of the right hilum due to pulmonary embolism in the right pulmonary artery- as well as pulmonary infarct involving the right middle lobe. CT scan showed the embolism in the right pulmonary artery with adjacent pulmonary infarct.

Discussion

Less than 10% of all pulmonary embolisms (PEs) lead to a pulmonary infarct, due to collateral vessels. Patients with underlying heart disease are more prone to infarction because of limited collateral circulation. Evidence of an infarction includes pleural effusion and wedge shaped opacity (Hampton hump). The Hampton hump is homogenous, located in the costophrenic sulcus and lacks air bronchograms. In embolism with infarction, airspace opacities take longer to resolve (weeks to months versus days in embolism without infarction).

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