March 2012 Imaging Case of the Month

Michael B. Gotway, MD

Associate Editor, Imaging

Clinical History: A 64-year-old woman presents with weight loss and an intermittent history of cough. Skin tuberculin testing was indeterminate, so a chest radiograph (Figure 1) was performed.

Figure 1:  Frontal (A) and lateral (B) chest radiographs show previous median sternotomy and mild cardiomegaly. Poorly defined, mildly hyperattenuating opacities are present in the apices bilaterally. No evidence of architectural distortion or cavitation is present. A calcified left mediastinal lymph node is present, consistent with prior granulomatous inflammation.

Does this chest radiograph show evidence of current or prior granulomatous infection?

1. True
2. False
3. Unknown

Reference as: Gotway MB. March 2012 imaging case of the month. Southwest J Pulm Crit Care 2012;4:80-7. (Click here for a PDF version of the case)