Atypical cavitary lung lesions : a case report and review of radiologic manifestations

Abstract

A 68-year-old woman presented to our emergency department with a 15 day history of epigastric discomfort radiating to the back. She had undergone a hysterectomy with bilateral salpingo-oophorectomy ten years before, for a FIGO stage 1 endometrioid adenocarcinoma. While abdominal examination was unremarkable, her liver function tests showed a cholestatic picture. An ultrasound scan of the abdomen revealed several gallstones as to the cause of this pain. Incidentally on chest radiograph, several lung lesions were noted bilaterally (Figure 1). On further questioning, the lady admitted to a one-year history of asthma with cough during the day and exertional dyspnoea. Inhaled corticosteroids prescribed for her ‘asthma’ proved to be ineffective. She was a non-smoker. She denied other respiratory symptoms, night sweats, chills, rigors or weight loss. She managed a good appetite and a good exercise tolerance for her age. There was no history of old TB, recurrent chest infections, recent travel or the presence of any mould at home.