Print Email
 

Clinical Images

What is Wrong With My Right Lung?

Sayed K. Ali MD, FACP and Hammad Bhatti MD

An 89 year old man with a history of hypertension, diabetes, COPD and remote tobacco use presented to clinic for an evaluation of a right middle lobe mass.  The patient had been previously treated at an outside hospital for community-acquired pneumonia, where a CT chest revealed a 2.7 x 3.8 cm right middle lobe mass with hilar lymphadenopathy and bronchiectasis (Figures 1 & 2).  A bronchoscopy was subsequently pursued showing partial narrowing of the middle lobe bronchus and was non diagnostic of a neoplastic process.  CT imaging of his brain, abdomen and pelvis also failed to show a malignant process.   A PET scan did not show any areas of increased uptake.   Ultimately a CT-guided biopsy of the lung lesion revealed some focal fibrosis with chronic inflammatory cell infiltrate.  
 

right-lung-1.jpg

 

right-lung2.jpg

 



Click here to view answer

References:
1. Blaivas AJ, Strauss W. Middle lobe syndrome in the left lower lobe in chronic obstructive pulmonary disease. Prim Care Resp J 2009;18(4):331-333 
2. Gudjartsson T, Gudmundsson G. Middle lobe syndrome: a review of the clinicopathological features, diagnosis and treatment. Respiration 2012;84(1):80-6

Authors:

Sayed K. Ali MD, FACP.  Faculty, Internal medicine, Palliative care. Orlando VAMC. Associate Professor University of Central Florida, College of Medicine.

Hammad Bhatti MD.  Faculty, Pulmonary Critical Care, Orlando VAMC. Assistant Professor, University of Central Florida, College of Medicine.

 



 

Submit content to JGIM

JGIM encourages submission of articles aimed at improving patient care, education, and research in primary care and general internal medicine in all settings. Submissions must be original and not currently under consideration for publication in another peer- reviewed medium (paper or electronic).

Learn How to Submit Here

 

FEATURED ARTICLE

 

Darlyn Victor, MD, Paul Moots, MD and Jacqueline Fischer, MD

October 13, 2016

A 39-year-old African-A....

Read Article
 

Most Viewed Articles

73 Views

The Role of Community-Based Participatory Research to Inform Local Health Policy: A Case Study.

O’Brien, Matthew J.; Whitaker, Robert C.

Read Article| Download PDF
25 Views

The Role of Community-Based Participatory Research to Inform Local Health Policy: A Case Study.

O’Brien, Matthew J.; Whitaker, Robert C.

Read Article| Download PDF
31 Views

The Role of Community-Based Participatory Research to Inform Local Health Policy: A Case Study.

O’Brien, Matthew J.; Whitaker, Robert C.

Read Article| Download PDF

Most Recent Web Only Content

January

17

On the Penetrating Capacity of Ultrasound

Sarah Bugg

Read Article

December

20

Painful Eruption in a Mountain Biker

Jasna Ikanovic, MD and Animita Saha, MD

Read Article

November

19

Adverse Events In US Hospitals:1 in 3 Admissions Has At Least One Adverse Event

SGIM Evidence-Based Medicine Task Force

Read Article

August

25

Diagnostic Schema

Denise M. Connor, Rabih Geha, Mark Henderson, Jeff Kohlwes

Read Article