case_images: PMC11447945_01
case_images: In March 2020 (Top row), the patient was seen for the first time. CT showed patchy nodules in the posterior basal segment of the right lower lung, with blurred edges and slightly higher-density arrows in the center. 2020.06 (Bottom row) Chest CT lung window, MRP oblique cross-sectional reconstruction. Pleural tunnel sign across the right oblique fissure (approximately 3.9 mm wide), the tunnel communicates with the cavitary lesion in the right upper lobe (arrow), accompanied by pneumothorax and pneumomediastinum.
case_images: fmed-11-1453043-g001.jpg
case_images: PMC11447945_01_fmed-11-1453043-g001.jpg
case_images: fig1
case_images: Amid persistent symptoms, he was hospitalized in March 2020, and pulmonary CT showed a patchy ground-glass shadow in the right lower lung (dorsal segment, outer, and posterior basal segments), potentially indicating an infection (Figure 1). Figure 1 shows the tunnel sign crossing the oblique fissure of the right lung.
case_images: July 15, 2020, the wall of the right upper lung cavity punctured for the second time; it was surrounded by non-uniform hazy rim (pathology confirmed as intra-alveolar blood accumulation, arrow), the solid part was slightly enhanced, and the CT value increased from 56HU to 63HU on plain scan.
case_images: fmed-11-1453043-g002.jpg
case_images: PMC11447945_01_fmed-11-1453043-g002.jpg
case_images: fig2
case_images: Chest CT revealed a new cavernous lesion with uneven wall thickness in the right upper lung, surrounded by a non-uniform hazy rim (Figure 2).
case_images: HE*100 lung tissue is accompanied by focal hemorrhage, necrosis, and fibrous tissue hyperplasia, hemosiderin-containing cell accumulation in the alveolar cavity, and a small amount of eosinophil infiltration.
case_images: fmed-11-1453043-g003.jpg
case_images: PMC11447945_01_fmed-11-1453043-g003.jpg
case_images: fig3
case_images: Figure 3 shows a small piece of lung tissue with focal hemorrhage, necrosis, fibrous tissue hyperplasia, aggregation of iron-containing hematoxylin in the alveolar cavity, and a small amount of eosinophil infiltrate.