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
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
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.
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.