CTICasesPulmonary Infarction Secondary to Tumor Vessel Encasement
Imaging findings
Chest radiograph and CT scan demonstrate a large, central right hilar mass associated with a wedge-shaped, peripheral consolidation in the right upper lobe. Coronal contrast-enhanced CT reconstructions show severe tumor encasement and extreme narrowing of the right upper lobe pulmonary artery branches, with absent distal vascular enhancement, indicating slow flow, ischemia, and subsequent peripheral pulmonary hemorrhage and infarction.
Key takeaways
Central lung tumors can cause severe encasement, compression, or direct invasion of adjacent pulmonary arteries and veins. This can lead to distal ischemia, slow flow, and pulmonary infarction, mimicking thromboembolic disease. The combination of a central hilar mass and a peripheral wedge-shaped opacity is sometimes referred to as a 'dumbbell' or 'barbell' pattern.
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