Caceres’ Corner: Case No.6 (Update Solution)

Caceres Corner Case 6Dear friends,

Welcome to Case #6. Let’s see what you make of this…

Clinical history: pre-operative chest radiograph for rhinoplasty in a 28-year-old male.

Diagnosis:

1. Middle lobe disease
2. Pleural effusion
3. Lung mass
4. None of the above

pre-operative chest radiograph for rhinoplasty, 28 year old male (lateral)

pre-operative chest radiograph for rhinoplasty, 28 year old male (lateral)

pre-operative chest radiograph for rhinoplasty, 28 year old male

pre-operative chest radiograph for rhinoplasty, 28 year old male (PA)

Click here for the answer to case #6

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    Nov 2011
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    DISCUSSION 24 Comments

    24 Responses to : Caceres’ Corner: Case No.6 (Update Solution)

    1. Catarina says:

      Pleural effusion

    2. Marius says:

      Scimitar syndrome +sequestration+ right subpulmonar pleural effusion ?

    3. Dimitris K says:

      Scimitar syndrome with pleural effusion.

    4. oana says:

      Right pulmonary hypoplasia with pleural effusion,the heart and mediastinal structures are shifted to right,tubular structure paralleling the right border of the heart(Scimitar sign) conected with IVC (supradiaphragmatic portion) – anomaulos pulmonary venous drainage.

    5. Adriana Calin says:

      3. pleural effusion

    6. Petite says:

      I think there is right pleural effusion, a thoracic asymmetry with a smaller right lung, right shifted mediastinum, some rounded opacities but in the RIL, not middle lobe(vascular origin probably) and some abnormal vessels in RL!

    7. amutha says:

      scimitar syndrome

      • José Caceres says:

        You are too smart! But have to brush uo inthe literature. Why is not a pleural effusion?

        • amutha says:

          this is not a pleural effusion [because pleural effusion cause a opacity with posterior upward slope of meniscus shaped contour in the lateral view]

        • amutha says:

          also there is rt volume loss – mediastinal shift towards the ipsilateral side[due to pulmonary hypoplasia] wheras in pleural effusion it will be to the contralateral side

    8. Anna says:

      I would rather vote for the lung mass but it would have been too easy (as we all know Mr. Muppet’s creativity;-)

    9. daliborka says:

      Pleural effusion + diaphragmatic hernia

    10. girish kulkarni says:

      -loss of volume involving right hemithorax.

      -right lower zone opacity silhouetting right cardiac border.

      -only the left hemidiaphragm seen on the lateral view.

      -blbous tubular opacity in the right paaravertebral region.

      possibilities are :

      – combined collapse of RUL and RML.

      – hypoplasia of right lung with rt paravertebral opacity representing scimitar/sequestration.

    11. Vilma says:

      sequestration + lung mass ( maybe in right main bronchus)+ pleural effusion

    12. Walo says:

      Right diaphragm herniation with prolaps of colon

    13. Nóra says:

      I would agree with Walo.

    14. aca says:

      hepatic transdiaphragmatic herniation with tortuos hepatic veins draining into vena cava inferior

    15. aca says:

      niceeee 🙂 must said ,i come last night from nightshift in Belgrade E.R. and thinking about this case for a very long time …now i can say,i was right:) thx mr. profesor for nice case you share with us

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