CXR Case 033

A 48 year old man is referred from the Chest Clinic with worsening breathlessness. SpO2 on air 85%, RR 18

CXR CASE 033 CXR LITFL

Describe and interpret this CXR

CHEST X-RAY INTERPRETATION

There are bilateral predominantly mid zone multifocal parenchymal infiltrates, worse on the left.

There is marked coarse fibrosis in the mid zones, worse on the left and affecting the horizontal fissure with some volume loss of the right upper lobe.


CLINICAL CORRELATION

This man has longstanding pulmonary and pleural fibrosis from sarcoidosis.

Old CXRs and CTs may help establish if any of the infiltrate is new, suggesting infection


CLINICAL PEARLS

Rarely, patients with progressive, treatment resistant sarcoid are referred for lung transplant.

*More recently some of the monoclonal antibody anti-TNF therapies such as inflixamab and adalimumab have been shown to have some efficacy in sarcoidosis.


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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