Faces of Cavitating Pneumonia or Consolidations

Size

Shape

Position
Bronchopneumonia

CT Bronchopneumonia
35-year-old woman, presents with dyspnea and fever. Coronal CT shows a bronchocentric pneumonic infiltrate in the superior segment of the left lower lobe and extending into the medial basal segment, (white ring), consistent with a bronchopneumonia. There is an adjacent region of ground glass infiltrate (red ring)
Courtesy Ashley Davidoff MD TheCommonVein.net 289Lu 136560c

Character

Infection Inflammation Malignancy Mechanical/Atelectasis Trauma Metabolic Circulatory- Hemorrhage Immune Infiltrative Idiopathic Iatrogenic Idiopathic

Infection

Cavitating TB with Transbronchial Spread

CT Active TB Cavitation and Ipsilateral Transbronchial Spread with Extensive Tree in Bud Pattern
39-year-old immigrant Vietnamese male presents night sweats, fever, and cough. CT in the coronal plane of the chest shows a large cavitating lesion in the right upper lobe, with innumerable micronodules dominantly in the right midlung field, and to lesser extent in the right upper lung field. Some micronodules are probably present in the left lower lobe as well. Close to the largest subsegmental consolidation there is a bronchus which shows thickening of its wall.
Although it has the appearance has a “miliary” pattern, this term is usually referred to the hematogenous spread of the disease
Ashley Davidoff MD TheCommonvein.net 135786c
006Lu

CT Active TB Cavitation in the Right Upper Lobe
39-year-old immigrant Vietnamese male presents night sweats fever and cough. CT in the axial plane of the chest shows a large cavitating lesion in the right upper apex.
Ashley Davidoff MD TheCommonvein.net 135787 006Lu 006Lu

CTPA reveals a large consolidation in the right upper lobe and superior segment of the right lower lobe spans approximately 8.8 x 5.6 x 9.4 cm and extends to the pleura. There are multiple internal cavitations (red arrows) with air-fluid levels. These large predominately right upper lobe cavitary lesions are consistent with clinical concern for tuberculosis pneumonia, however follow-up with chest CT in 3 months post-treatment is recommended to exclude other less likely causes of cavitary lesions, such as malignancy.
Courtesy Joseph Cannella, Dr. Christina LeBedis, MD, MS TheCommonVein.net

Cavitating Left Lower Lobe Pneumonia with Pseudoaneurysm (PSA)

Cavitating Left Lower Lobe Pneumonia
30-year-old female with a history of IVDU presents with a fever and hemoptysis.
CT in the axial plane shows a cavitating pneumonia in the anterior segment of the left lower lobe. There are groundglass changes surrounding the consolidation representing either edema or hemorrhage
Ashley Davidoff MD TheCommonVein.net 281Lu 136524

Inflammation
Neoplasm Mucin Secreting Adenocarcinoma

85 year old male with a mucin secreting adenocarcinoma associated with air bronchograms or findings of cavitation (bubble lucencies -pseudocavitation)
Ashley Davidoff
TheCommonVein.net
118601

Circulatory Disorders
Immune Disorders

Wegener’s Granulomatosis Granulomatosis with Polyangiitis