Journal Mobile

S Khalid, S Bailey, C Houghton
Journal Issue: 
Volume 37: Issue 4: 2007




Pulmonary embolism presenting as a cavitating lesion on a chest X-ray is described in a patient with a six-week history of worsening dyspnoea.  A chest X-ray performed 27 days earlier did not show the cavitating lesion.  On the day of presentation,  the  patient  had  developed  streak  haemoptysis. Due  to  the progressive  nature  of  dyspnoea,  hypoxia  and  the  rapid  development  of  the cavitating lesion on the X-ray, pulmonary infarction leading to cavitation secondary to pulmonary thromboembolism was considered to be among the list of differential diagnoses. The modified Wells criteria for this patient were 2·5 (Heart rate > 100, haemoptysis). This diagnosis was confirmed on CTPA, which showed the presence of  large  pulmonary  emboli  in  the  pulmonary  vasculature  supplying  the  affected lobe.  Subsequent Doppler ultrasound revealed the presence of a below right knee thrombosis. Although rare, cavitation has previously been observed in patients with pulmonary thromboembolism