CXR Case 034

CXR Interpretation:
This AP film has an irregular thin walled large cavity in the medial right mid zone.
The hilar vessels are visible suggesting it is situated either posteriorly or anteriorly .
There are coarse reticular markings in the right middle lobe and lingular lobes suggestive of bronchiectasis.

Lateral CXR Interpretation:
The lateral confirms the presence of a cavity in the right apical segment of the lower lobe. There is no fluid level.
The is some scattered surrounding airspace shadowing (consolidation)

There is a single large cavity and evidence of chronic lung disease and the history suggests a more recent deterioration.
Relevant differentials include lung cancer (classically squamous cell) and infection.

A maturing pulmonary infarct from PE can cavitate.

*TB should be considered as mycobacterium are frequently found in this pattern of bronchiectasis.*

If there is a draining bronchus there won’t necessarily be a fluid level in an abscess caused by infection.