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Age: 6

Sex: Male

Indication: Respiratory distress

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Case #43


Findings

  • Opacity in the medial aspect of the superior segment of the right lower lobe, which has a tubular configuration on the frontal view
  • No pleural effusion or pneumothorax
  • Normal size and configuration of the cardiopericardial silhouette


Diagnosis

  • Arteriovenous malformation (AVM)

Sample Report

Opacity in the medial aspect of the superior segment of the right lower lobe, which has a tubular configuration on the frontal view. While this could represent pneumonia, recommend followup radiographs in 2 weeks to ensure resolution. If the opacity persists at that time, recommend chest CT for further evaluation.

No pleural effusion or pneumothorax.

Normal size and configuration of the cardiopericardial silhouette.


Discussion

  • The apparent hyperinflation on this case was not present on a repeat lateral view, and therefore was related to patient effort rather than air trapping
  • If an opacity does not look typical for pneumonia, recommend followup radiographs
  • This patient was later diagnosed with Hereditary Hemorrhagic Telangiectasia (HHT) and was also found to have several small intracranial AVMs


Images

Red arrow: medial right lung opacity with a somewhat tubular configuration. Red arrow: corresponding opacity in the superior segment of the right lower lobe on the lateral view. Red arrow: tangle of vessels demonstrated on the subsequent chest CT consistent with AVM.

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