Correct!
4. Unenhanced chest CT shows that foci of ground-glass opacity and consolidation have evolved and contracted into subpleural nodular foci
Axial unenhanced chest CT shows that areas of ground-glass opacity and consolidation have partially resolved and contracted into subpleural nodular foci. While nodular opacities are indeed developing, they are restricted to the subpleural regions of the left upper and lower lobes; the right lung is not involved. The prominent smooth interlobular septal thickening seen on previous CT scans has regressed. The left pleural effusion- small- has remained stable. No pericardial effusion is evident.
An outside CT of the chest (Figure 7) was located, performed 6 months prior to the patient’s presentation chest radiograph and CT, obtained for pulmonary venous radiofrequency ablation planning for the patient’s atrial fibrillation.
Figure 7. Representative images from axial enhanced chest CT displayed in soft tissue and lung windows performed for atrial fibrillation ablation planning showing normal findings.
Despite several physician encounters over the course of the patient’s presentation, she had failed to mention she had undergone this procedure at an outside facility. This study showed no previous underlying structural lung disease, excluding the possibility of previous differential diagnostic considerations, particularly multicentric mucinous adenocarcinoma. Given the newly discovered history of catheter radiofrequency pulmonary venous isolation / ablation, cardiology was consulted and recommended contrast enhanced chest CT (Figure 8).
Figure 8. Left: Representative images fromaxial enhanced chest CT displayed soft tissue (A-F) and lung windows (G and H), as well as sagittal reconstructions displayed in soft tissue windows (I and J). Right: video of chest CT in soft tissue windows.
Which of the following represents an appropriate interpretation of this chest CT? (Click on the correct answer to be directed to the page 8 of 10 pages)