Cáceres’ Corner Case 225 – SOLVED

Dear Friends,

Today’s radiographs belong to a 37-year-old man with moderate fever.
What do you think?

Come back on Friday to see the answer!

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Findings: Chest radiographs show an intrapulmonary rounded opacity with ill-defined borders in the left lung (A-B, arrows). In a patient with fever and no other significant symptoms, the most likely diagnosis should be rounded pneumonia, although I was somewhat concerned about the good definition of the lower contour in the lateral view (B, red arrows), which is unusual in pneumonia.

The patient improved with treatment and follow-up radiographs four weeks later show only minimal residual findings in the PA view (C, arrow).

Final diagnosis: rounded pneumonia simulating a pulmonary mass.

Congratulations to Ahmad, who was the first to give the correct diagnosis. Silver medal to Sara Mercado/span>, who arrived second three hours later.

Teaching point: remember that not all pulmonary nodules/masses are malignant. If you want to know more about them, look up Diploma #51 “Innocuous pulmonary nodules”

4 thoughts on “Cáceres’ Corner Case 225 – SOLVED

  1. Good morning!! Thank you for livening up the time of the coronavirus!!!!!

    There is a round lesion in LLL, with ill-defined lateral borders so we can´t conlude that the lesion is intrapulmonary. Perhaps it can be a pleural lesion… No costal erosion…

    Pleural abscess/loculated empyema?

  2. relatively large, round opacity in LLL, poorly defined, with air-fluid level inside; most likely an abscess; no associated lesions visible

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