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DICOM HelpSource: Local (us-east1-c)
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Demographics:
31 years old, Male
Indication:
Dyspnea
Findings
Chest radiograph
- Widespread interstitial thickening with patchy right midlung and bibasilar opacities
CT
Chest
- Mild widespread interlobular septal thickening
- Diffuse patchy groundglass opacities
- Mild dependent left lower lobe consolidation
- Trace left pleural effusion
- Mild atherosclerotic calcification of the left anterior descending coronary artery
- Hypoattenuation of the unenhanced blood pool
- Trace pericardial effusion
Upper abdomen
- Atrophic left kidney
MSK
- No acute findings
Diagnosis
Diffuse alveolar hemorrhage (Goodpasture syndrome)
Sample Report
Widespread patchy groundglass opacities which could relate to noncardiogenic pulmonary edema, drug reaction, pulmonary hemorrhage, or atypical infection. Consider bronchoscopy for further diagnostic evaluation.
Dependent consolidation in the left lower lobe likely represents atelectasis although aspiration and/or pneumonia is not excluded.
Trace left pleural effusion.
CT findings suggestive of anemia.
Atrophic left kidney.
Discussion
- Patients with diffuse alveolar hemorrhage (DAH) will not necessarily present with hemoptysis
- Make sure not to forget hemorrhage as a potential cause for alveolar opacification
- In a young patient with diffuse alveolar opacities and renal atrophy, pulmonary-renal syndromes like Goodpasture syndrome should be a primary concern