‘Routine‘ CXR on a 64 year old female attending the emergency department after an hour of central chest pain
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
There is a calcified suprahilar lymph node on the right (station 4R).
Remaining mediastinum, lung parenchyma and pleural are normal.
This is old tuberculosis (TB).
Any history of active disease (cough, fevers, weight loss) should be sought – although this is likely decades old
The use of corticosteroids for immune suppression, chemotherapy and immune modulators such as anti-TNF for inflammatory arthritis are all associated with reactivation of old TB.