CTICasesChronic Pulmonary Thromboembolism (Incidental Finding)
Imaging findings
On a CT performed for another indication, the left lower lobe pulmonary artery is noted to abruptly terminate beyond a certain level with no arteries identified distally, bronchial collaterals supplying that region, and a black-smoke phenomenon of slow, opacified blood flow returning to the left atrium through the left lower lobe.
Key takeaways
These findings are typical of localized chronic pulmonary thromboembolism involving the left lower lobe pulmonary vessels; comparison with a prior radiograph from 2016 showing diminished vessel caliber in the same region relative to the contralateral lung indicated that the finding had already been present at that time, illustrating how chronic pulmonary thromboembolism can be an incidental, longstanding finding discovered only in retrospect.
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