Caceres’ Corner Case 112 (Update: Solution)


Dear Friends,

Today we are showing PA radiographs of a 55-year-old woman, asymptomatic. The image presented is a reconstruction of a CT examination (no radiograph available). Muppet believes it is worth showing because it is an unusual disease and has teaching value. What do you see?

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

PA chest

Click here for the answer to case #112

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    Mar 2015
    DISCUSSION 34 Comments

    34 Responses to : Caceres’ Corner Case 112 (Update: Solution)

    1. Iffat Rehman says:

      Pectus excavatum

    2. Aleksander Marin says:

      The oesophagus appears diffusely dense?

      • Aleksander Marin says:

        Also the position of gas in the stomach is displaced higher and to the midline is unusual.
        The fact she is asymptomatic makes me consider this has to be something chronic.
        Or is there something in her history for a CT scan.
        Calcified wall of lower thirds of the oesophagus. Considerations: Leomioma, old intramural hepatoma of the oesophagus.
        Would love to see the CT images.

    3. Dr Ramesh K Pandey says:

      Hmmm…oesophagus showing stent outline…could be post malignancy stricture oesophagus

    4. Tedi says:

      Middle and lower third of oesophagus is dilated with irregular narrowing at the esophageal-cardiac junction. I would go with scleroderma .

    5. j.d. says:

      Figure of 7 ribs, heart slightly diaplaced to left allowing on mild rotated hest position. This is pectus excavatum.
      Lining of oesophagus probably due to oral contrast ingestion on CT table, the distal part at relaxation phase. No lung changes to supposrt acleroderma.

    6. Jose Caceres says:

      Do not waste your time with the esophagus. remember this is a reconstruction of a CT examination.
      Look carefully. The abnormality is visible.

    7. kuba says:

      Left hemithorax is hyperlucent. Poland syndrome maybe?

    8. dr.akshay says:

      ther is increased broncho vascular marking viz. on rt side,if im not wrong ther is either central line or pt is intubated n tube is in rt bronchus…increase B-V marking suggest either br.asthma or pul. edema…

    9. Dmitriy says:

      hiatal hernia

    10. Eola says:

      Midline stomach. Could it be some kind of situs ambiguous?

    11. dr Asmaa says:

      Lt hemidiaphragm

    12. Aleksander Marin says:

      I see a vessel like structure behind the medial right hemidiaphragm – Scimitar syndrome?

    13. Amir parsa says:

      I think left sterno clavivular joint or internal end of lt clavicle is abnormal ,mybe stefnoclavicular syndrom,,,

    14. Tobster says:

      Small caliber pulmonary vessels, especially right-sided…curved tubular opacity in the base of the lung on the right, would agree to what Aleksander proposes…suggestive of Scimitar.

    15. ula says:

      swyer james syndrome?

    16. gus says:

      11th rib absence?

    17. Borsuk says:

      Is it change of left clavicule near sternum? Variant of anatomy?

    18. Genchi Bari Italia says:

      ….pazza, pazza, pazza idea……migrazione endotoracica di una protesi endovascolare dall’ aorta addominale…..ottimo BARCA!!!!!!

    19. Peppa says:

      Scimitar sy.

    20. say says:

      Bilateral hyperluce lungs barrell chest .?COPD

    21. Ali says:

      Scimitar !

    22. genchi bari italia says:

      …l’anomalia potrebbe essere la congenita occlusione delle due vene polmonari: esse non sono rappresentate ed al loro posto ci sono sottili diramazioni vascolari, che rappresentano il circolo collaterale di scarico….

    23. Nikos says:

      could that be an intrathoracic rib?

    24. Aleksandr Mogila says:

      Fracture of acromial part of the right clavicula.

    25. Atis says:

      Alexander Marin is very smart. The more you know, the more you know 🙂
      Prof. thanks for the case, can’t wait to see CT!