July 2012 Imaging Case of the Month

Michael B. Gotway, MD

Associate Editor, Imaging

Clinical History: A 24-year-old non-smoking man presents to the emergency room with hemoptysis, cough, fever, and chest pain. Frontal and lateral chest radiography (Figures 1A and B) was performed.

Figure 1. Frontal (A) and lateral (B) chest radiography shows opacity in the medial left lung base. No clear evidence of air bronchograms is evident, no pleural abnormality is seen, and no lymphadenopathy is present.

Which of the differential diagnostic considerations listed below is the most likely consideration for the appearance of the lesion on the chest radiograph?

1. Bronchogenic carcinoma
2. A congenital pulmonary lesion
3. A mediastinal germ cell neoplasm
4. A Morgagni diaphragmatic hernia
5. Pneumocystis jiroveci pneumonia

Reference as: Gotway MB. July 2012 imaging case of the month. Soutwest J Pulm Crit Care 2012;5:24-32. (click here for a PDF version of the case)