Elsevier

Clinical Radiology

Volume 37, Issue 4, January–November 1986, Pages 327-333
Clinical Radiology

The radiology of aseptic cavitation in pulmonary infarction

https://doi.org/10.1016/S0009-9260(86)80263-XGet rights and content

Eight patients with aseptic cavitation of sterile pulmonary infarcts are described. All except one had left ventricular failure and/or chronic airflow obstruction. Infarcts with cavities were commonly single (75%) and right-sided (69%) and usually followed a sizeable area of consolidation (larger than 4 cm) after about 2 weeks. Of the 62% that could be localised to a segment, all were in the apical or posterior segment of an upper lobe or the apical segment of a lower lobe and the majority (85%) had scalloped inner margins and cross cavity band shadows. At the time of cavitation, 38% had additional features on the chest radiograph that were suggestive of pulmonary embolic disease. A number of cavities developed a tertiary infection and an air-fluid level but the latter feature was non-specific. Aseptic cavitation of a sterile pulmonary infarct should be considered in the differential diagnosis of any cavitating lung lesion, particularly if it shows the above features.

References (39)

  • SiskP.B.

    Roentgenogram of the month

    Diseases of the Chest

    (1964)
  • VidalE. et al.

    Lung abscess secondary to pulmonary infarction

    Annals of Thoracic Surgery

    (1971)
  • WestJ.B.

    Distribution of mechanical stress in the lung, a possible factor in the localization of pulmonary disease

    Lancet

    (1971)
  • AldersonP.O. et al.

    Scintigraphic detection of pulmonary embolism in patients with obstructive pulmonary disease

    Radiology

    (1981)
  • AroraY.C. et al.

    Unusual clinical and roentgenographic features of pulmonary infarction

    American Review of Respiratory Disease

    (1960)
  • BartlettJ.G. et al.

    Anaerobic infections of the lung and pleural space

    American Review of Respiratory Disease

    (1974)
  • BielloD.R. et al.

    Ventilation-perfusion studies in suspected pulmonary embolism

    American Journal of Roentgenology

    (1979)
  • BuchananD.R. et al.

    Saprophytic invasion of infarcted pulmonary tissue by Aspergillus species

    Thorax

    (1982)
  • CarterW.D. et al.

    Relative accuracy of two diagnostic schemes for detection of pulmonary embolism by ventilationperfusion scintigraphy

    Radiology

    (1982)
  • Cited by (37)

    • Pulmonary infarction in acute pulmonary embolism

      2021, Thrombosis Research
      Citation Excerpt :

      The infarcted tissue is an ideal culture medium and may become infected via the tracheobronchial tree or due to circulating organisms if transient bacteremia occurs. (73–75) The prevalence of cavitation in PE-related pulmonary infarction is 3.4–7%. (74–76) The mean time to cavitation has been reported to be 14–18 days. (74,75)

    • Successful Resection of Rapidly Growing Cavitary Infarction After Pulmonary Emboli

      2021, Annals of Thoracic Surgery
      Citation Excerpt :

      Cavitary PI is rare, reportedly occurring in 4% to 7% of all cases of PI.1 Risk factors for PI with cavitation reportedly include a >4-cm consolidation shadow, older age, heart failure, chronic lung disease, and immunosuppression,2-7 which indicates insufficient intrapulmonary blood flow. Once superinfection occurs in a bland infarction, lack of intrapulmonary blood flow due to PE prevents a sufficient effect of intravenous antibiotics and contributes to an increased risk of continued infection.

    View all citing articles on Scopus
    View full text