case_images: PMC6243302_01
case_images: Frontal chest X-ray demonstrating a right lower lobe ill-defined opacity (arrow).
case_images: bjrcr.20150430.g001.jpg
case_images: PMC6243302_01_bjrcr.20150430.g001.jpg
case_images: fig1
case_images: Her initial chest X-ray showed an opacity in the right lower lobe (RLL) contiguous with the right hemidiaphragm (Figure 1).
case_images: Axial contrast-enhanced CT scan of the chest in soft tissue window demonstrating a right lower lobe solid nodule (arrow) with central calcified focus.
case_images: bjrcr.20150430.g002.jpg
case_images: PMC6243302_01_bjrcr.20150430.g002.jpg
case_images: fig2
case_images: A CT pulmonary angiogram demonstrated a 2.8 cm solid enhancing nodule in the posterobasal segment of the RLL with a density measuring 35 HU, with a 7 mm central focus of dense calcification (Figure 2); also noted were hyperdense endobronchial material in the RLL, which was thought to represent fresh blood.
case_images: Axial non-contrast CT scan (a), FDG-PET scan (b), and fused PET/CT scan (c) showing focal increased FDG uptake within the right lower lobe nodule (arrows), maximum standardized uptake value of 5. FDG, 18F-fludeoxyglucose; PET, positron emission tomography.
case_images: bjrcr.20150430.g003.jpg
case_images: PMC6243302_01_bjrcr.20150430.g003.jpg
case_images: fig3
case_images: Positron emission tomography revealed increased 18F-fludeoxyglucose (FDG) uptake [maximum standardized uptake value (SUVmax) of 5] within the RLL nodule; the report described the finding as concerning for malignancy, with the differential diagnosis of an inflammatory pseudotumour (Figure 3).
case_images: Axial contrast-enhanced CT scan of the abdomen demonstrating multiple spilt gallstones within Morison's pouch (arrows).
case_images: bjrcr.20150430.g004.jpg
case_images: PMC6243302_01_bjrcr.20150430.g004.jpg
case_images: fig4
case_images: The relevant externally performed images have been retrieved, including a CT scan of the abdomen (Figure 4).
case_images: Fresh unopened lung wedge resection with staple line at the surgical margin, there is a defect on one side of this (black arrow). Separately received off-white to brown rhomboid stone (white arrow).
case_images: bjrcr.20150430.g005.jpg
case_images: PMC6243302_01_bjrcr.20150430.g005.jpg
case_images: fig5
case_images: A firm rhomboid-shaped calculus measuring 11 x 7 x 8 mm (Figure 5) that dislodged from the specimen was confirmed to be a gallstone.