CXR Case 021

A 64 year old female presents with worsening breathlessness and cough over 2 weeks

CXR CASE 021 LITFL

Describe and interpret this CXR

CHEST X-RAY INTERPRETATION

There are widespread, patchy rounded infiltrates of varying size throughout both lung fields.

The infiltrates appear more confluent and dense in the lower lobes, perhaps representing some consolidation.

Some of the lesions in the upper zones appear to be cavitating.


CLINICAL CORRELATION

Possible differentials for this appearance include:
• cavitating pulmonary metastases (e.g. squamous cell, adenocarcinoma from GI tract or breast, sarcoma)
• septic pulmonary emboli
• Granulomatosis with Polyangiitis


CLINICAL PEARLS

The increased density and size of the lesions in the lower lobes favor haematological spread of, in this case, lung metastases.


TOP 150 CXR SERIES



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 |

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