Prediction of Pulmonary Embolism Following Resection of Pulmonary Infarction: A Case Series

Figures

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  Fig. 1. (A) Radiographic findings of four cases of pulmonary infarction (PI). CT findings showing all four nodules located in the subpleural lesion of the peripheral lung (red arrows). (B) A trabecular-shaped shadow is seen in a sagittal section of the CT scan in case 3 (red arrow). (C) Axial CT imaging on initial visit (blue arrow). The size of the nodule increased progressively over 4 months (yellow arrow).

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  Fig. 2. Intraoperative and pathological findings of case 3. (A) Intraoperative findings showing pleural indentation corresponding to spicula on CT. (B) Macroscopic findings. On the cut surface of the resected specimen, scattered irregular orange solid areas are found in the nodule (red arrows). A loupe view (hematoxylin and eosin staining) shows nodular, irregular-shaped lesions located in the peripheral and subpleural lung parenchyma (red arrowheads). (C) Microscopic findings representing necrosis, part of which involves vessels surrounded by fibrosis and the infiltration of histiocytes and other mononuclear cells. The orange-colored region corresponds to hemosiderin-laden histocytes. (D) Berlin blue staining highlights hemosiderin-laden histiocytes. (E) Elastica–Masson staining. There is a vascular narrowing and/or occlusion in part of the collapsed lesion.

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  Fig. 3. Clinical course of case 3. (A) CT scan shows large pulmonary thrombus in the left main pulmonary artery 8 months after surgery. This decreases in size and disappears after starting anticoagulation therapy (red arrowheads). (B) A thrombus is found in the left femoral vein when the diagnosis of pulmonary embolism (PE) is made, and it is considered to be the cause of the PE (yellow arrowhead).