Caceres’ Corner: Case No.5 (Update: Solution)

Dear friends,

Welcome to case #5.

Case #5 is also from my wife. It is a 27-year-old female with a chronic infiltrate in the right upper lobe. My Wife asked us (ordered, according to Muppet) to help her with the case, because she doesn’t know what it is.

Diagnosis:

1. Tuberculosis
2. Aspiration pneumonia
3. Bronchioalveolar carcinoma
4. Lymphoma

I didn’t make the diagnosis, but the Muppet did! What is the Muppet’s diagnosis?

Lateral chest

PA chest

N.B. The quality of the films is not excellent, but they give enough information to allow diagnosis. Disregard the increased opacity in both middle lung fields; this is due to overlapping breast prosthesis.

Click here for the answer to case #5

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    Nov 2011
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    DISCUSSION 28 Comments

    28 Responses to : Caceres’ Corner: Case No.5 (Update: Solution)

    1. raishad says:

      aspiration pneumonia

    2. babita jangid says:

      chronic infiltration in this pt is going in favour of tuberculosis.

    3. Laura says:

      Tuberculosis

    4. Petite says:

      2.aspiration pneumonia

    5. Dimitrios Kaimenakis says:

      It’s no 1:Tuberculosis

    6. Adela Montelongo Martín says:

      I think it may be tuberculosis.

    7. Amutha says:

      aspiration pneumonitis as dilated esophagus noted[esophageal motility disorder-achalasia cardia]

    8. Andrea Lakatos says:

      Tuberculosis

    9. Nuria says:

      Right hilium seems to be higuer than left hilium, so it seems that RUL has left volume.
      I think there are some calcified nodes at the right hilium (maybe it is my imagination!!)These findings lead me to think about tuberculosis, but there are other findings such as wide right paratracheal line and double right heart contour that support achalasia diagnosis (dilatated esophagus, therefor aspiration pneumonia

    10. matteo quarenghi says:

      megaoesophagus with aspiration pneumonitis

    11. Ieva says:

      I would like to know the patient’s clinical findings and prior radiographs BUT as it looks now – with somewhat nodular infiltrates in the right upper lobe I would first think of tuberculosis.
      For untreated lymphoma I would have liked to see more dense cnsolidations.
      In a young woman, who I assume is mobile (she is not laying supine) I would not suspect aspiration in the right upper lobe.

    12. girish kulkarni says:

      -multiple airspace and nodular opacities in the right upper and midzones.

      -prominent left paraesophageal line on PA view and anteriorly displaced trachea on the lateral view consistent with distended esophagus.

      possibilitis are :

      -distal esophageal obstruction (achalasia or any other cause) with aspiration pneumonitis.

      -small esophgeal perforation with esophago-pulmonary fistula.

    13. Andrea Contegiacomo says:

      Tubercolosis

    14. pallavi gupta says:

      aspiration pneumonia

    15. Lola la Piconera says:

      2.Aspiration pneumonia.

      Achalasia (lateral view) thick tracheoesophageal line, increased density of retrotracheal space and forward convex posterior tracheal wall + RUL loose of volume(Did she have previous breast cancer and radiotherapy?).

    16. pagkalidou elena says:

      aspiration pneumonia

    17. Mohammed F. Amin says:

      Tuberculosis

    18. Livia says:

      Tuberculosis

    19. gianluigi says:

      aspiration pneumonia due to achalasia

    20. Vilma says:

      Aspiration pneumonia

    21. Medya says:

      Tuberculosis

    22. Medya says:

      Tuberculosis
      as the lesion is in the posterior segment of right upper lobe

    23. dana says:

      #2.Aspiration pneumonia

    24. fatih says:

      maybe tuberculosis

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