Eighty-five-year-old man with mosaic attenuation on chest imaging

Description

An 85-year-old man presented with worsening dyspnea and non-productive cough ongoing for 3 days prior to the admission. The patient denied any fever, chills, chest pain, palpitations, orthopnoea or paroxysmal nocturnal dyspnoea. Physical examination was remarkable for mild respiratory distress without any additional findings on auscultation. Social history was significant for >20 pack-year history of smoking. Vitals on admission: blood pressure 138/85, heart rate 92 bpm, respiratory rate 22, pO₂ 94% on room air. EKG was noticeable for normal sinus rhythm with ventricular rate of 87, without any ST-T wave changes.

A chest X-ray (CXR) was significant for hyperlucent lungs (figure 1). CT of chest without Intravenous contrast was performed to evaluate for possible atypical infection that could have been missed on the CXR.1 Areas of hypoattenuation are visible on the scan (figure 2A).

Figure 1

Chest X-ray showing hyperlucent lungs.

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