Caceres’ Corner Case 146 (Update: Solution)

esr_2016_blog-cacerescorner-146

Dear Friends,

Today we’re showing chest radiographs of a 57-year-old man with chest pain and dyspnoea.

Check the images below, leave your thoughts in the comments, and come back on Friday for the answer.

Diagnosis:

1. Carcinoma of the lung
2. Thymoma
3. Lymphoma
4. None of the above


pa-chest

lateral-chest

Click here for the answer to case #146

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24
Oct 2016
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DISCUSSION 16 Comments

16 Responses to : Caceres’ Corner Case 146 (Update: Solution)

  1. MK says:

    There is a superior tracheal shift towards the left side, but it´s inferior portion is displaced towards the contrateral side.
    In the lateral view there is a partially obliterated retrosternal space.
    I think there are signs of atelectasia of the LUL, well delimitated for the major fissure, and I think that a Golden´s sign is visible.
    The left bronchious is elevated and the cardiac silhouette is missing.

    I think that the correct answer is a carcinoma of the lung with hiliar/mediastinal adenopathy.

  2. marian says:

    Giant aortic arch aneurysm?

  3. Mark says:

    On the PA radiograph there is an oval mass adjacent to the mediastinum on the left, causing displacement of the distal trachea to the right. On the lateral view this mass appears to be in the middle portion of the mediastinum. Additionally on the PA, there is opacification of the left hemithorax with visible bronchogams, as well as silhouetting of the heart and the medial portion of the left hemidiaphragm. On the lateral view there seems to be a wedge-shaped density overlaying the cardiac silhouette along the anterior portion of the left major fissure. These findings may represent a thymoma with an associated collapse of the left upper lobe.

  4. Vesna says:

    Interlobar pleural effusion!!!

  5. Mahmoud says:

    1-There is volume loss in left upper lobe evidenced by superior displacement of major fissure on lateral view, horizontal orientation of left main bronchus on PA view and leftward displacement of trachea in PA view. Finding are suggestive of left upper lobe collapse
    2- the obvious mass in PA view turns to be in middle mediastinum in lateral view and the retrosternal air space on lateral view appear enough lucent to exclude thymoma and lymphoma as a cause of this large opacity.
    Finally, my diagnosis is carcinoma of the lung complicated by left upper lobe collapse.

  6. abu-rahmeh zuheir says:

    carcinoma of the upper lobe .

  7. Alberto Montemayor says:

    colapso del lobulo superior izquuierdo por un cancer del pulmon

  8. Jose Caceres says:

    By the way, did anybody look at the right lung?

  9. MK says:

    Perhaps at least 2 pulmonary nodules? One in the URL and the other in the LRL

  10. Mahmoud says:

    We didn’t see because of satisfaction syndrome

  11. Genchi Bari italia says:

    ….bulking linfoma con atelettasia lobo polmonare superiore sx.

  12. Wael Mohamed Abd Al Azeem says:

    thymoma

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