COD 194 - 2 Years, All 3 Vessel Sizes, One Diagnosis

A 37-year-old man was treated for Lemierre's syndrome, then TB, then presumed ANCA-associated vasculitis. Every label turned out to be wrong.

Over 2 years, his disease moved through large, medium, and small vessels — carotid and subclavian arteritis, aortitis with SMA and celiac involvement, and waxing-waning lung lesions that behaved exactly like ANCA-associated vasculitis but with persistently negative serology. The final diagnosis only became clear after multiple findings had manifested in space and time.

This case walks through the full imaging timeline from Oct 2023 to Jan 2026, the missteps along the way, and the clinical clues that finally pointed to the answer.

Vasculitis Posts

Post 08 - Multifocal Peribronchovasular Consolidation

The pattern of peribronchovascular consolidation and its differentials

CT Chest ReviewBhavin Jankharia

Case 83: The Constant Diagnostic Confounder

This entity has multiple presentations and can be tough to diagnose only on radiology

CT Chest ReviewBhavin Jankharia

Index and Table of Contents

116 Cases with Videos
9 Cases with Posts
31 Snippets
16 Lectures
34 Cases of the Day (CODs)
New Series - ILD Patterns (2 Done)

Index and Table of Contents

Technical and Practice Issues * Case 11: 62-years old misdiagnosed to have interstitial lung disease - mid-inspiratory and expiratory scans * Snippet 03: Radiation risk and CT chest * Case 23: 60-years old - 40-pack years smoker - right upper lobe nodule - resolved using “mean” reconstructions…

CT Chest ReviewBhavin Jankharia

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Previous Posts:

Post 09 - Not Miliary TB: High-Density, Variable-Sized Nodules in a Flour-Mill Worker

Not all small nodules are miliary. A history often helps getting to the diagnosis.

CT Chest ReviewBhavin Jankharia

Snippet 31 - Radiotherapy-Associated Lung Injury

Radiotherapy-associated lung injury follows predictable patterns. History of radiotherapy, knowledge of the portal, and timelines are what separate this entity from infection, chemotherapy-induced ILD, or recurrent disease.

CT Chest ReviewBhavin Jankharia