Presentation
Presents for coughing up blood three weeks previously. Today is lethargic and panting.
Patient Data
The cardiovascular structures are normal in size and shape. There is a moderate amount of air in the pleural space with apparent elevation of the heart from the sternum. There is a round soft tissue opacity nodule in the right middle lung lobe that is superimposed on the heart on the left lateral projection.There is air and fluid in the esophagus. The stomach contains a linear metallic wire and linear soft tissue opacities.
The pulmonary nodule was confirmed on thoracic ultrasound. It appears as a hypoechoic oval structure that begins at the pleural surface and extends into the lung (calipers). Fine needle aspirates were non-diagnostic.
The pulmonary nodule and pneumothorax had resolved two weeks after the initial visit.
Case Discussion
Differential diagnoses were inhaled foreign body with secondary pneumothorax and inflammatory nodules or neoplasia with rupture. On recheck radiographs two weeks later, the pneumothorax and the pulmonary nodule had resolved, making foreign material and inflammation the primary cause.
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