CXR Case 074

There is a large mass in the medial right lung adjacent to the mediastinum.
The airway and right inferior pulmonary artery are clearly visualized, suggesting this is posterior to the hilum.
Lung fields, pleura and bones otherwise normal.

Lateral X-ray confirms the presence of a large mass, posterior to the hilum.

This is very likely to be a primary lung cancer.

Smoking history, occupational exposures (particularly asbestos) and additional clinical features such as dyspnoea and weight loss should be gained.

Haemoptysis occurs in at least 1 in 5 cases of non small cell lung cancer.

In the majority of cases it is relatively minor and can be managed by stopping any anti-platelet and/or anticoagulants and monitoring closely.

Occasionally tranexamic acid is useful.