CXR Case 108

A 49 year old lady who is a current smoker presents with cough, dyspnoea and fever.

click images to enlarge


Describe and interpret this CXR

CHEST X-RAY INTERPRETATION

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.


CLINICAL CORRELATION

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


CLINICAL PEARLS

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.


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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