CXR Case 043
An 85 year old lady presents with worsening dyspnoea and chronic cough
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
There is bilateral apical pleural calcification, more pronounced on the right.
There is additional right upper lobe fibrosis and traction causing the right hilum to be elevated, mediastinal shift and volume loss on the right side.
This lady has old Right upper lobe (RUL) and pleural TB.
She will likely have chronic airways limitation due from the architectural distortion.
Bilateral apical pleural calcification like this is highly likely old TB.
Unilateral apical calcification is most likely TB, although previous haemothorax or empyema are other causes.
Asbestos related pleural plaque does not affect the apicies.
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