CTICasesIn-Situ Right Pulmonary Artery Thrombosis
Imaging findings
Serial chest radiographs and CT scans demonstrate progressive volume loss, severe bronchiectasis, and parenchymal destruction of the right lung due to severe, chronic tuberculosis. Over time, a large, expanding, non-occlusive filling defect develops within the right pulmonary artery, consistent with an in-situ thrombosis secondary to sluggish flow in the severely damaged lung.
Key takeaways
Similar to a pulmonary artery stump thrombosis after lobectomy or pneumonectomy, severe chronic inflammatory parenchymal diseases like tuberculosis can destroy the distal pulmonary vascular bed. The resulting stagnant, low-flow state in the main pulmonary artery branch predisposes the patient to in-situ thrombosis, which can progressively enlarge.
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