A patient with a history of COPD / severe emphysema presents with weight loss, some pleuritic chest pain, and an exacerbation of their shortness of breath.
What does this ultrasound clip demonstrate?
- This clip shows a small, well defined peripheral lung metastasis in an emphysematous lung.
- There is a well defined hypoechoic solid lesion. It is within the lung and slides with respiratory movement. The regular, rounded borders are unlike the irregular, poorly defined “shredded” borders of pneumonia, and unlike the wedge shape one can see with pleural infarction. The rounded convex surface at the pleural surface is also evident. These features are typical of a small rounded peripheral lung metastasis.
- Further examination revealed these were numerous.
- The lung surface is particularly smooth and devoid of the normal comet tail artefacts and occasional B-lines. This is characteristic of emphysematous lung.
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