CXR Case 075

A 61 year old man is sent in by his GP after having a CXR for persistent cough

click images to enlarge


Describe and interpret this CXR and CT chest

IMAGE INTERPRETATION

CXR Interpretation:
There is a rounded, spiculated opacity projected over the right hilum. Otherwise, lung fields, pleura and bones appear normal.

CT Chest Interpretation:
CT chest demonstrates a rounded mass abutting the anterior mediastinum


CLINICAL CORRELATION

This is probably a primary lung cancer.

The absence of any other tumours in the chest (as confirmed by CT) make metastases far less likely.


CLINICAL PEARLS

On the original CXR, the right inferior pulmonary artery (and other hilar structures) are visible through the lesion – meaning that the lesion must be either anterior or posterior to the hilum itself because of the different density of normal aerated lung between the two (similar density) structures.


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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