February 2015 Imaging Case of the Month

Michael B. Gotway, MD

Department of Radiology

Mayo Clinic Arizona

Scottsdale, AZ

Clinical History: A 37-year-old man, a former smoker (quit 10 years ago) presented to his physician as an outpatient with complaints of intermittent chest pain, malaise, and intermittent fever. Stress ECG and upper endoscopy were negative. His previous medical history was otherwise unremarkable. Various physicians told the patient his symptoms were due to “stress”; presumptive antibiotic treatment had no effect.

Frontal chest radiography (Figure 1) was performed.

Figure 1. Frontal chest radiography.

Which of the following statements regarding the chest radiograph is most accurate? (Click on the correct answer to proceed to the second of five panels)

1. The chest radiograph shows a circumscribed pulmonary mass
2. The chest radiograph shows asymmetric pulmonary vascularity
3. The chest radiograph shows bilateral linear and reticular opacities and diminished lung volumes suggesting fibrotic lung disease
4. The chest radiograph shows cardiomegaly and small pleural effusions
5. The chest radiograph shows numerous small nodules

Reference as: Gotway MB. February 2015 imaging case of the month. Soutwest J Pulm Crit Care. 2015:10(2):70-6. doi: http://dx.doi.org/10.13175/swjpcc018-15 PDF