June 2012 imaging case of the month

• Main Author: Gotway MB
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2012-06-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: carcinoid tumor; hemoptysis; lung mass; neuroendocrine cell neoplasms
• Online Access: http://www.swjpcc.com/imaging/2012/6/29/june-2012-imaging-case-of-the-month.html?SSScrollPosition=335

No abstract available. Article truncated at 150 words. Clinical History: A 46 -year-old man presents to the emergency room with hemoptysis. Frontal and lateral chest radiography (Figures 1A and B) was performed.Figure 1. Frontal and lateral chest radiography shows a lobulated, circumscribed lesion within the left hilum. The right hilum appears normal, no lung consolidation is present, and no pleural abnormalities are seen. There is no evidence of mediastinal lymph node enlargement. There is relative lucency involving the left lung, particularly the left upper lobe, compared with the right side.Which of the differential diagnostic considerations listed below is the least likely consideration for the appearance of the lesion on the chest radiograph?1.Bronchogenic carcinoma2.Adenoid cystic carcinoma3.Carcinoid tumor4.Sarcoidosis5.Allergic bronchopulmonary aspergillosis Correct!4. SarcoidosisChest radiography shows a unilateral lobulated, circumscribed mass in the left hilum; the right hilum and mediastinum are normal. Lucency in the left lung, particularly left upper lobe, suggests air trapping. These findings indicate a lesion arising from or involving the airway. All the choices above, except sarcoidosis, commonly involve the large airways and may present as a central hilar masses associated with bronchial obstruction. In contrast, while sarcoidosis may present with hilar enlargement due to lymphadenopathy, the hilar nodal involvement is commonly symmetric and frequently accompanied by mediastinal lymph node enlargement; the latter is not present in this case. Furthermore, sarcoidosis is rarely associated with central unilateral endobronchial obstruction. ...