CTICasesPatchy Pulmonary Edema in Severe Emphysema
Imaging findings
Chest radiograph and CT in a patient with severe emphysema and fluid overload show atypical, patchy ground-glass and consolidative opacities. The fluid accumulates in the preserved septa and parenchyma between large, air-filled emphysematous bullae, simulating multifocal infection.
Key takeaways
Severe emphysema dramatically alters the radiographic and CT appearance of pulmonary edema. Because the lung parenchyma is destroyed and replaced by air-filled spaces, edema fluid cannot distribute uniformly or layer gravitationally. It instead accumulates in a patchy, interstitial-like pattern that can easily be mistaken for multifocal pneumonia.
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