CTICasesPulmonary Coccidioidomycosis with Regional Lymphadenopathy and Interstitial Edema
Imaging findings
Frontal and lateral chest radiographs show ill-defined consolidative opacity confined to the right lower lobe, accompanied by subtle septal lines. Chest computed tomography reveals extensive, bulky paratracheal, subcarinal, and hilar lymphadenopathy alongside right lower lobe consolidation, dense septal lines, small nodules, and peribronchial cuffing, simulating a primary lung cancer with lymphangitic carcinomatosis.
Key takeaways
Pulmonary coccidioidomycosis can present with severe, unilateral interstitial edema and extensive, bulky regional mediastinal and hilar lymphadenopathy. The localized interstitial edema may result from lymphatic obstruction caused by the severe regional lymphadenitis.
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