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