**6. Conclusion**

220 Venous Thrombosis – Principles and Practice

The most striking and unexpected findings was contrast-enhanced computed tomography (CT) scan of blood vessels and identification of filling defect in the main pulmonary arteries which presumptive diagnosis of pneumonia excluded. There were pulmonary consolidation with central cavitation on the right lower and left upper lobes too. The diameter of right and left consolidation was 63 x 75 mm and 85 x 70 mm respectively (**Figure 3a and 3b**). The size of pulmonary infarct , in our case, is grater than 40 x 40 mm which explain the appearance of cavitation. Also, the velocity of cavity formation presented in our case is significantly lower than literature data pointed out. Venous duplex ultrasound of lower extremitas was negative for deep-vein thrombosis. Low-molecular heparin were

Fig. 3a. and 3b. Contrast - enhanced computed tomography scan of blood vessels showing filling defect in the main pulmonary arteries with central cavitation on the right lower and

left upper lobes too

administered immediately after the findings of the CT scans were obtained.

Cavitary pulmonary infarct is a rare but frequently misdiagnosed disease entity. Differentation between cavitary pulmonary infarct and multiple complications or other diseases can be a real challenge because of the similar radiographic abnormalities and clinical presentation of all this conditions. In the cases with clinical suspicion to "pneumonia" unresponsive to chemotherapy images studies are of great help. The best evidence of infarction is the angiographic demonstration of pulmonary thromboemboli. Anticoagulant and antibiotic treatment in the cases of infected cavitary pulmonary infarct must be started immediately after the diagnosis is established.
