CXR Case 057

An 89 year old man presents with increasing tiredness and lethargy

CXR CASE 057 CXR LITFL

Describe and interpret this CXR

CHEST X-RAY INTERPRETATION

There is a large, rounded mass in the right upper zone.
There are multiple small rounded opacities in the right mid and lower zones.
The aorta is unfolded. Bones look normal.


CLINICAL CORRELATION

This is a large cancer originating within the lung parenchyma with smaller ipsilateral metastases; bone scan revealed multiple bony metastases.

Fine needle aspirate (FNA) revealed a poorly differentiated large cell carcinoma. He had a raised serum PSA but no definitive prostate immunohistochemical stains.


CLINICAL PEARLS

The concave angle(s) between the mass and the pleura indicate that this mass has originated from the lung.

A convex angle would usually lend toward a pleural based origin.


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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