Hemorrhagic pulmonary infarction
Imaging findings
Chest CT shows a dense, wedge-shaped consolidative opacity in the posterior basal segment of the left lower lobe demonstrating a high-attenuation peripheral rim ('rind' or blood orange sign) and low-attenuation center, without air bronchograms, associated with a large filling defect (pulmonary embolism) in the corresponding segmental artery.
Key takeaways
Hemorrhagic pulmonary infarction secondary to pulmonary embolism can mimic pneumonia or lung cancer on CT. The 'blood orange sign' represents a high-attenuation peripheral rim of hemorrhage with central necrosis and ground glass, and the absence of air bronchograms helps differentiate infarction from infectious pneumonia.
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