June 2012 Imaging Case of the Month

Michael B. Gotway, MD

Associate Editor, Imaging

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 carcinoma
2. Adenoid cystic carcinoma
3. Carcinoid tumor
4. Sarcoidosis
5. Allergic bronchopulmonary aspergillosis

 Reference as: Gotway MB. June 2012 imaging case of the month. Southwest J Pulm Crit Care 2012;4:214-21. (click here for a PDF version of the manuscript)