Extensive Multisegmental Bronchiectasis Presenting As a Transient Parahilar Coin Lesion

¹ Cardiopulmonary Laboratory
² Director, Cardiopulmonary Laboratory; Associate Professor of Clinical Medicine
³ Chief, Pulmonary Diseases

The finding of a 2 cm parahilar coin lesion in a patient with hemoptysis suggests a variety of etiologies including neoplastic disease. Of considerable interest in the present case, however, was the disappearance of the coin lesion in the upright chest roentgenogram shortly after admission. Tomography demonstrated cystic changes in the apex of the left lower lobe in place of the former nodular lesion. Further investigation by means of bronchography revealed the true nature of the underlying disease process, namely, saccular bronchiectasis. This report illustrates an unusual radiologic presentation or bronchiectatic disease and emphasizes the need to consider the bronchiectatic sac filled with debris in the differential diagnosis of the pulmonary coin lesion.