Caceres’ Corner Case 103 (Update: Solution)


Dear Friends,

Muppet is afraid of losing our audience and insists on showing easy cases. Here we are presenting radiographs belonging to a 54-year-old man with skin lesions.
What do you see? Check the images below, leave your thoughts in the comments section, and come back on Friday for the answer.

PA chest

lateral chest

Click here for the answer to case #103

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    Nov 2014
    DISCUSSION 18 Comments

    18 Responses to : Caceres’ Corner Case 103 (Update: Solution)

    1. Adam says:

      Interstitial opacities, increased lung volume, skin lesions and an easy case – could it be NF1?

    2. Ivan says:

      rugger jersey spine?

    3. Maria B says:

      Myelofibrosis and cutaneous extramedullary hematopoiesis

    4. Tony says:

      Langerhans Cell Histiocytosis would explain the interstitial parenchymal changes, the rash and the destruction of the 8th rib on the right side, with my first differential being a tumor with metastasis in the rib and paraneoplastic rash.

    5. asdf says:

      Lungs appears “dirty” to me.
      Interstitial opacities with reticulo-nodular pattern.
      Can’t tell if it’s only due to my monitor: there is permeative pattern in few ribs/verterbra.

      and those skin lesions..
      Dear proffesor can You provide us with picture of that lesion(s).

      My guess:
      – Mycosis fungoides or
      – HIV (+): kaposi’s sarcoma & Opportunistic pneumonia & lymphoma

    6. Dr Chalo says:

      …Churg-Strauss syndrome…?

    7. Fares says:

      Increased interstitial markings, especially bibasal + dilated esophagus on lateral view + skin lesions = Scleroderma is the first diagnosis.
      Small amount of pleural effusion, egg-shell cacified mediastinal lymph nodes and signs of pulmonary hypertension may be found in cases of scleroderma.

      • Jose Caceres says:

        I disagree with you about the dilated esophagus in the lateral view. And the retrotracheal line has a normal thickness.

    8. Murzin says:

      Did the patient smoke?

    9. gus says:


    10. gus says:

      The other hypothesis is Superior vena cava syndrome.
      There is widening on the frontal view of the upper mediastinum on the right, and i think there is swelling of the right hilum too.

    11. genchi bari italia says:

      ….io penso che la patologia sia a carico del “contenente ” e non del “contenuto”….i corpi vertebrali sono addensati con sindesmofiti ….e nello spazio intercostale dx tra 7 ed 8 costa si vede una tenue e disomogenea opacità che potrebbe essere a carico delle parti molli della parete, sede della patologia cutanea… diagnosi? Psoriasi e rachide di tipo infiammatorio….

    12. fernando says:

      Diffuse lytic and sclerotic bony lesions. Mastocitosis.