Metastatic Pulmonary Hepatoid Carcinoma with Vascular Complications and Transplanted Kidney

Matthias Stefan May, MD
Department of Radiology, University Hospital Erlangen, Germany
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A 74-year-old male patient came to the hospital complaining of increasing shortness of breath. A chest radiograph showed a triangular opacity in the periphery of the left lung, possibly indicating a pulmonary embolism (PE). An abdominal ultrasound examination revealed a possible abdominal aortic aneurysm (AAA). The patient had a history of right hip replacement and chronic claudication with right lower limb pain. A decade ago, he underwent kidney transplantation, and currently had an estimated glomerular filtration rate (GFR) of 70.3 mL/min/ 1.73m². TwinBeam Dual Energy (TBDE) CT was performed to rule out PE and to investigate the systemic arterial circulation, using only a single bolus injection and thereby keeping the iodine charge as low as possible.