CXR Case 025

56 year old male with a recent diagnosis of lung cancer presents with dyspnoea. What treatment has he been receiving?

CXR CASE 025 LITFL

Describe and interpret this CXR

CHEST X-RAY INTERPRETATION

There is consolidation with a sharply delineated lateral margin on the right side and some patchy changes on the left


CLINICAL CORRELATION

Radiation pneumonitis refers to the acute phase of radiation-induced lung disease (RILD).

Onset of symptoms is typically between 4 and 12 weeks post radiotherapy, though may be earlier.

Symptoms vary from mild to the more severe and include cough, dyspnoea, low grade fever and pleuritic chest pain.

Patients can become markedly hypoxaemic, depending on how much lung is affected.

Differentials can include infection, lymphangitis, hypersensitivity to chemotherapy or other drugs, heart failure or PE.

*In this case the strongly demarcated line is an indication of the edge of the radiation field *


CLINICAL PEARLS

High dose corticosteroid therapy is indicated for radiation pneumonitis.


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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