40 Round Pneumonia

Clinical Presentation

A previously well 4-year-old presents with acute onset cough, leukocytosis, and fever.

Figure 40A

Radiologic Findings

The AP chest radiograph shows spherical mass-like areas of soft tissue in the right upper lobe of the lung, which is sharply defined and with uniform opacity consistent with typical “round pneumonias” (Fig. 40A).

Figure 40B (1,2) Standard chest radiographs of a child with cough and fever showing well-defined and sharply marginated areas of soft tissue density within the lung, consistent with typical round pneumonias.

Figure 40C Large, sharply marginated left perihilar soft tissue masslike opacity in the region of the superior segment of the left lower lobe in a child with cough and fever.

Diagnosis

Round pneumonia

Differential Diagnosis

Round atelectasis
“Pseudo-tumor” (plasma cell granuloma)
Neurogenic mass (if posterior)
Solitary metastasis (rarely attain the size of a round pneumonia, especially in the absence of a known primary malignancy)