case_images: PMC5760875_01
case_images: Patient with leg ulcer with sickle cell disease and pulmonary hypertension
case_images: LI-35-73-g001.jpg
case_images: PMC5760875_01_LI-35-73-g001.jpg
case_images: F1
case_images: Apart from the SCD, the patient had a history of chronic venous stasis ulcer, which was being managed on an outpatient basis [Figure 1].
case_images: (a and b) Computed tomography of the chest showing a diffuse mosaic attenuation of the lung parenchyma
case_images: LI-35-73-g002.jpg
case_images: PMC5760875_01_LI-35-73-g002.jpg
case_images: F2
case_images: For further evaluation, the patient had a computed tomography pulmonary angiogram (CTPA), which demonstrated diffuse mosaic attenuation of lung parenchyma as seen in diseases such as chronic thromboembolic (CTE) disease [Figure 2a and b]. A mildly dilated pulmonary artery was also noted [Figure 2a].
case_images: (a) Pulmonary angiogram showing filling defects in the right middle lobe and right lower lobe. (b) Pulmonary angiogram showing filling defects on the left side
case_images: LI-35-73-g005.jpg
case_images: PMC5760875_01_LI-35-73-g005.jpg
case_images: F3
case_images: The pulmonary angiogram demonstrated filling defects in the right lower and middle lobes and left lower lobe, consistent with CTE disease [Figure 3a and b].
case_images: Clot removed after pulmonary thromboendarterectomy
case_images: LI-35-73-g007.jpg
case_images: PMC5760875_01_LI-35-73-g007.jpg
case_images: F4
case_images: Two months later, the patient underwent a successful pulmonary endarterectomy (PEA) with removal of the thrombus [Figure 4].
case_images: Healing lung ulcer status post pulmonary thromboendarterectomy
case_images: LI-35-73-g008.jpg
case_images: PMC5760875_01_LI-35-73-g008.jpg
case_images: F5
case_images: Interestingly, on follow-up, it was also noted that the patient's chronic venous stasis ulcer showed remarkable improvement with improvement in his oxygen saturation and improvement in his functional status [Figure 5].