CLINICAL DETAILS:
SLE. Immunosuppressed. On steroids and cylco. Cough++. Dull right base. ?Effusion.
CHEST:
The heart size is at the upper limits of normal. There is slight lateral peaking of the left hemidiaphragm, raising the possibility of a small left subpulmonary effusion. The right pleural space appears clear. There is no focal consolidation.
The heart is enlarged. There is increased opacity behind the heart silhouetting the descending aorta and the left hemidiaphragm. There is also blunting of the right costophrenic angle and pulmonary venous hypertension. There is no definite evidence of consolidation in the right lung.
NM LUNG SCAN V/Q:
There is a large reversed mismatch in the left lower lobe typical of a pleural effusion. There is also a minimal degree of reversed mismatch also at the right base. No other defects can be seen.
COMMENT:
No evidence to suggest pulmonary embolism.
