CXR Case 017
67 year old male presents with shortness of breath, cough and significant weight loss. He had a bronchoscpy the following day.
click images to enlarge
Describe and interpret this CXR and subsequent bronchoscopy
CHEST X-RAY INTERPRETATION
There is volume loss in the right hemithorax with collapse of the right upper lobe.
*There is patchy consolidation in the right lower and middle lobes*
Bronchoscopy reveals a large obstructing polypoid mass in the right main bronchus.
The tumour was snared and removed using cautery – its origin was from the right upper lobe.
*The patchy consolidation in the lower and middle lobes is from post-obstructive pneumonia.*
Many endobronchial tumours are benign (e.g. hamartoma), although squamous cell cancer or carcinoid are frequently found.
Prof Fraser Brims Curtin Medical School, acute and respiratory medicine specialist, immediate care in sport doc, ex-Royal Navy, academic| Top 100 CXR | Google Scholar | ICIS Course ANZ
Cxr case 017
Is there right side pleural effusion ?
I guess there could be – not a characteristic meniscus laterally, or at least the consolidation around makes it hard to tell. Remember you can hide ~500mls pleural fluid in the costophrenic angle on standard PA film…