Pulmonary embolism with Hampton's hump.

Abstract

Introduction A middle-aged adult, who had been hospitalized because of acute ischemic stroke, complained of sudden shortness of breath on the second day of admission. On physical examination, he was afebrile and normotensive and had no abnormal breathing sounds. Laboratory tests revealed abnormal levels of fibrinogen, fibrin degradation products, and D-dimer, which were all elevated (D-dimer level: 15.9 mg/l fibrinogen equivalent unit; reference range: 0–0.55). Computed tomography (CT) was performed under the tentative diagnosis of pulmonary embolism on the basis of the patient’s clinical history and abnormal coagulation profile. CT of the chest showed filling defects (arrows) consistent with emboli in the main pulmonary trunk bilaterally (Fig. 1) and a focal wedge-shaped Hampton’s hump, which indicated a pleura-based infarction (arrow) of the corresponding arterial territory in the superior segment of the right lower lobe (Fig. 2). The patient’s condition deteriorated despite aggressive medical treatment and he died from respiratory failure.