A 67-year-old woman with abnormal lung perfusion scan finding.

Content Provider	Semantic Scholar
Author	Dhillon, Samjot Singh Bag, Remzi Fisher, Ron
Copyright Year	2004
Abstract	A 67-year-old woman with multiple myeloma and recently treated left upper pneumonia was admitted to the hospital for acute-onset shortness of breath. Chest radiography showed a left upper lobe infiltrate. CT angiography revealed right-sided pulmonary embolus. IV heparin was started through a new right subclavian central venous catheter. The patient was then transferred to the Methodist Hospital for further care. Physical examination revealed BP of 106/60 mm Hg, pulse of 110 beats/min, respiratory rate of 24 breaths/min, and pulse oximetry showed 98% saturation on 4 L/min O2 by nasal cannula. The patient had a generalized tonic-clonic seizure on the second day of hospital admission, and MRI of the brain showed a small infarct in the right posterior temporal lobe. Serum electrolytes were within normal range, and workup for hyperviscosity syndrome and meningitis was not pursued as the patient had rapid resolution of symptoms. A lung perfusion scan using IV Tc macroaggregated albumin (MAA) was performed, and images of the brain and kidney were obtained to look for a possible shunt. Perfusion scan showed marked tracer uptake in the right upper extremity, right cerebral hemisphere, and right cerebellum, but absence of perfusion to a majority of the left side of the brain, left face, left side of the neck (Fig 1), and left upper extremity (Fig 2).
Starting Page	892
Ending Page	904
Page Count	13
File Format	PDF HTM / HTML
Alternate Webpage(s)	http://journal.publications.chestnet.org/pdfaccess.ashx?url=/data/journals/chest/22008/1941.pdf
PubMed reference number	15136410v1
Volume Number	125
Issue Number	5
Journal	Chest
Language	English
Access Restriction	Open
Subject Keyword	ALBUMIN,IODINATED I-131 SERUM Central venous catheter, device Cerebellum Cerebral Infarction Cerebral hemisphere structure (body structure) Dyspnea Electrolytes Hospital admission Intravenous Catheters Limb structure Lung diseases Meningitis Mercury Multiple Myeloma Oximetry, Pulse Oxygen saturation measurement Patients Plain chest X-ray Pneumocystis jiroveci pneumonia Portion of respiratory air Pulmonary Embolism Radiographic imaging procedure Renal Tissue Seizures, Clonic Structure of left upper lobe of lung Structure of upper lobe of lung Technetium Temporal Lobe Tonic - clonic seizures Tracer Upper Extremity X-Ray Computed Tomography angiogram beats per minute breaths per minute heparin hyperviscosity syndrome
Content Type	Text
Resource Type	Article