September 2015 Imaging Case of the Month

Philip W. Ho, M.D.

Clinton Jokerst, M.D.

Department of Medical Imaging

Banner University Medical Center

Tucson, AZ

Clinical History: A 51-year-old white man with a past medical history significant for weight, loss, hypertension and a 60 pack-year smoking history presented to the emergency department with hemoptysis and chest pain. He was afebrile with an unremarkable CBC. Frontal chest radiography (Figure 1) was obtained.

Figure 1. Frontal chest radiography.

There are multiple large pulmonary nodules scattered throughout both lungs. Which is the least likely diagnosis? (Click on the correct answer to proceed to the second of five panels)

1. Fungal infection
2. Granulomatosis with polyangiitis (GPA)
3. Metastatic disease
4. Septic emboli

Reference as: Ho PW, Jokerst C. September 2015 imaging case of the month. Southwest J Pulm Crit Care. 2015;11(3):105-9. doi: http://dx.doi.org/10.13175/swjpcc109-15 PDF