What the .....?" Yup, that's what the tech said after the injection of MAA into the left arm, after the initial ventilation scan.
Indication: Rule out any significant pulmonary hypertension. Pre-op assessment.
Findings: Preliminary flow study demonstrates extensive collateralization of the left chest wall. Matched and unmatched perfusion defects in both lungs. Impression, low probability for pulmonary embolism. Possible left subclavian obstruction.
Hx: Pulmonary hypertension is not one of the indications for a VQ scan, unless they have had a chronic history of a pulmonary embolism (PE). The thoracic surgeon ordered this test to ensure that there were no complications before they performed an open biopsy on the left lung. The patient had previous non Hodgkin's lymphoma, was experiencing SOB, reduced lung capactiy from the PFT study, developed hemoptysis, fever and chills. Based on the CT and a failed FNA, the open biopsy would help to figure out if there was a relapse in the lymphoma or lung fibrosis or some other inflammatory disease.
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