School ager with hypercoagulable state with respiratory distress

CXR, VQ scan, angiogram of pulmonary embolism / pulmonary embolus / PE
CXR AP (above) shows a large wedge shaped infiltrate in the right lower lobe and a right pleural effusion. Ventilation image from a V/Q scan (middle left) shows normal ventilation to both lungs. Perfusion image from a V/Q scan (middle right) shows essentially no perfusion to the right lung. PA image from a pulmonary angiogram shows a near complete lack of blood flow to the right lung.

The diagnosis was right pulmonary embolism.