Case presentation

A 94-year-old female patient was referred to the emergency department of our hospital for cough productive of purulent sputum and recurrent episodes of haemoptysis. She was a mild, former smoker. Her medical history was notable for a left-sided pleuropulmonary infection treated for months with antibiotics at the age of 2 years, and for recurrent respiratory infections occurring ever since. Chest CT revealed multiple abnormalities of the left lung consisting of a marked volume loss; diffuse bronchiectasis prevailing in the upper lobe, where a large airway consolidation was also evident; and multiple centrilobular nodules of variable sizes (figure 1A,B). Furthermore, a reduction of the lumen of the left main stem bronchus associated with possible fractures of some …