Demographics:
63 years old, Male
Indication:
Chest pain, cough
Findings
Chest radiograph
- Moderate-sized, multiloculated left pleural fluid collection
- Patchy left basilar opacities
CT
Chest
- Moderate-sized, multiloculated left pleural collection with associated visceral and parietal pleural thickening
- Dependent consolidation in the left lower lobe
- Mildly enlarged mediastinal and left pleural lymph nodes, likely reactive
- Mild centrilobular and paraseptal emphysema
- Small rounded filling defect in the left ventricular apex
Upper abdomen
- No acute findings
- 1.5 cm intermediate density right adrenal nodule
- Adreniform thickening of the left adrenal gland without discrete nodule
MSK
- No acute findings
- Remote right posterior ninth rib fracture
Diagnosis
Empyema
Sample Report
Findings concerning for left lower lobe pneumonia with a moderate-sized, multiloculated left empyema.
Small rounded filling defect in the left ventricular apex concerning for thrombus. Consider echocardiography for further evaluation.
Indeterminate right adrenal nodule. Recommend adrenal protocol CT or MRI for further evaluation if no prior imaging is available to document stability.
Discussion