Figure 14. .

Pulmonary embolism in a patient with suspected acute exacerbation of interstitial lung disease. 73-year-old male known for drug-induced pulmonary fibrosis (a) (chemotherapy for high-grade bladder carcinoma), presenting with increasing dyspnea, fever and oxygen desaturation. Although a new GGO was observed and attributed to fibrosis exacerbation (b), pulmonary emboli were detected on this contrast-enhanced chest CT (c). Note the triangular opacity corresponding to a small intrafissural effusion in (b). This example highlights the importance of performing a contrast-enhanced CT in case of clinical worsening in patients with pulmonary fibrosis to rule out pulmonary embolism, since acute exacerbation is a diagnosis of exclusion. GGO, ground glass opacity.