Case 4 - Suspected Pulmonary Edema with CT for Differential

Exam: XR Chest
CLINICAL INDICATION: Shortness of breath.
COMPARISON: None available.
FINDINGS:
SUPPORT DEVICES: Spinal stimulator device projects over the midline of the
thorax.
LUNGS/PLEURA: There is a generalized haziness to the lungs, with a fine
reticular pattern seen throughout the lungs. No pleural effusion or
pneumothorax.
HEART AND MEDIASTINUM: The cardiac contour and mediastinum appear normal.
BONES AND SOFT TISSUES: No acute abnormality.
IMPRESSION: Findings may represent noncardiogenic pulmonary edema, multifocal
infection or acute lung injury.
RECOMMENDATIONS: None.
COMMUNICATION: Routine.

Examination: CT Chest w/ Contrast
CLINICAL INDICATION: Shortness of Breath
TECHNIQUE: Written informed consent was obtained. Non-gated spiral axial images
of the chest were obtained with nonionic intravenous contrast according to a
pulmonary embolism protocol. There were no immediate complications reported.
COMPARISON: Chest x-ray 3/21/2017
FINDINGS:
PULMONARY ARTERIES:
Study is diagnostic the level of the subsegmental pulmonary arteries. No
pulmonary embolism is present.
MEDIASTINUM/HEART/VESSELS:
Mild cardiomegaly. No pericardial effusion. Minimal punctate atherosclerotic
plaque at the origin of the left anterior descending coronary artery. Punctate
atherosclerotic plaque near the origin of the right main coronary artery. No
enlarged or suspicious supraclavicular, axillary, or mediastinal lymph nodes.
Mild circumferential thickening of the distal esophagus.
AIRWAY/LUNGS/PLEURA:
Multifocal areas of ground glass opacification most prominent in the upper lobes
and dependent lower lobes with central distribution. Smaller areas of dependent
consolidation. No pleural effusion or pneumothorax. The central airways are
clear.
VISIBLE ABDOMEN:
Large exophytic cystic low density structure arising off the superior pole of
the left kidney is partially imaged and represents a possible renal cyst.
Incidental small splenule. Scattered diverticulosis of the transverse colon
without evidence of diverticulitis.
SOFT TISSUES/BONES:
Status post placement of spinal stimulator. No acute or suspicious abnormality.
IMPRESSION:
Negative for pulmonary embolism.
Multiple bilateral patchy ground-glass pulmonary opacities and interlobular
septal thickening with a central lung distribution suggesting pulmonary edema.
Indeterminate circumferential distal esophageal wall thickening, which is a
non-specific finding that may be related to esophagitis (such as may be seen in
the setting of gastroesophageal reflux).