CTICasesAsymmetric Pneumocystis jirovecii Pneumonia
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Imaging findings
Chest radiograph shows asymmetric opacities in the left lung compared to the right, along with small cystic spaces. CT of the chest demonstrates striking, highly asymmetric ground-glass consolidation primarily in the left lung, several small cystic foci, bronchial wall thickening, and a large, complex, thick-walled cavitary lesion centered in the lingula that does not directly communicate with the bronchus.
Key takeaways
Pneumocystis jirovecii pneumonia (PJP) typically presents with bilateral, symmetric ground-glass opacities, but it can manifest asymmetrically and can be associated with thin- or thick-walled cysts and pneumatoceles. In immunocompromised patients with AIDS, complex cavitary or mass-like presentations should raise suspicion for PJP or superimposed infections, and diagnosis is typically confirmed via bronchoscopy.
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