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CTPA

Findings: There is airspace opacity in the anterior right upper lobe with air bronchograms compatible with pneumonia. Several cystic lesions are seen within the consolidation include a dominant lesion measuring 1.1 cm which may represent cavitation versus cystic bronchiectasis. Bronchiectasis is seen central to the cystic lesions. There is no pleural effusion. The pulmonary arteries are normal without filling defects to suggest either acute or chronic pulmonary emboli. The heart and great vessels, pleura, and diaphragms are normal. There is no evidence of mediastinal, hilar or axillary lymphadenopathy. The visualized upper abdominal viscera and the osseous structures are unremarkable. Impression: 1. Findings compatible with right upper lobe pneumonia. Given cystic areas within the consolidation, this may be consistent with mycobacterial or nonmycobacterial tuberculous, or other fungal infection. Less likely considerations include neoplastic or inflammatory causes. Recommend pulmonary consultation and followup imaging to document resolution. 2. No evidence of pulmonary embolism. ------------------------- Evolving airspace opacifications surround the relatively unchanged areas of fibrocavitary disease in the left lung base. Left basilar bronchiectasis is unchanged. A small focus of atelectasis is noted in the right lung base. Numerous bilateral nodules are noted, grossly unchanged from prior. There is no pneumothorax. There is no mediastinal mass or hilar lymphadenopathy. Diffuse nodular appearance of the liver is again noted with enlarged left lobe of the liver. Findings are likely related to underlying cirrhosis. Visualized abdominal viscera otherwise demonstrate no significant abnormality, stable from the prior study. Multilevel degenerative changes of the thoracic spine are noted without evidence of acute osseous abnormality. Atherosclerotic calcifications are noted in the aorta. Impression: 1. No evidence of pulmonary embolism. 2. Findings compatible with left basilar MAC infection; slightly worsened in appearance from most recent comparison. Specifically, evolving consolidation along the posterior aspect of the fibrocavitary changes. 3. Multiple bilateral pulmonary nodules, possibly infectious or inflammatory. It should be noted that this examination is not optimized for the evaluation of pulmonary nodules. Followup as deemed clinically appropriate. 4. Other stable findings; see comments above.