Pulmonary septic emboli
27 yo M, h/o IV drug use, presented with chest pain. CT with contrast performed according to the PE protocol shows a 2.2 cm nodule in the peripheral right upper lobe, with a subtle central cavitation.
On spectral analysis, the nodule has markedly decreased iodine uptake. This case is somewhat unusual in that patient aslo has a obvious pulmonary artery embolus in the right lower lobe.
Careful analysis shows a small filling defect adjacent to the tricuspid valve, and a dilated right atrium. Tricuspid endocarditis confirmed on echocardiography.