CXR Case 108

CXR Interpretation:
There is a mass-like area of increased airspace shadowing in the right upper zone, in continuity with the mediastinum.
The right upper lobe bronchus is visualized running through it.
The horizontal fissure appears more prominent than normal.
The pleural spaces are clear, the left side appears normal.

Lateral Interpretation:
The opacification more clearly abuts the horizontal fissure and sits in the posterior segment of the right upper lobe.

This is pneumonia affecting the right upper lobe, posterior segment. The differential would include a malignancy.

CT may help distinguish between infection vs. malignancy although usually treating for infection with repeat imaging at 6-8 weeks later is required to ensure the consolidation and likely (reactive) adenopathy has resolved.