Caceres’ Corner Case 135 (Update: Solution)


Dear Friends,

Today I am showing the second case of the “five easy pieces”. It is a PA radiograph of a 51-year-old woman for pre-op surgery of umbilical hernia. What do you see?

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

PA chest

Click here for the answer to case #135

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    Apr 2016
    DISCUSSION 22 Comments

    22 Responses to : Caceres’ Corner Case 135 (Update: Solution)

    1. Olena says:

      There is additional homogeneous round opacity in the right hila – needs lateral veiw

      Differential diagnosis – bronchopulmonary cyst with fluid ? mediastinal mass?

      The shadow of aortic deformation from aortic arch to the level of diaphram, which deforms the carina – it shifts carina to the right

    2. Adyarjagadish says:

      Rt hilar mass

    3. huseyin says:

      honeycomb on the left overview for interstitial lung disease? + Minimal pleural effusion = scleroderma?
      right mediastinal lap sarcoidosis ?

    4. Borsuk says:

      Opacification of left-lower part of trachea and round opacity in a right hilum. I suspect npl of bronchi with lymphadenopathy.

    5. Stevan says:

      Paracardiac oval shaped opacity below right hilum, without silhouette sign, therefore probably situated posteriorly – bronchogenic cyst is my first suspect.
      Slightly blunted costophrenic sulci, probably of no significance.

    6. sht says:

      CP angles blunted.Right hilum full.
      Aortic shadow within normal limits.
      Junction line visible superior aspect aortic knuckle.

      Any back pain?

    7. Maria says:

      Round opacity, below the right hilum, probably situated posteriorly – lung cancer?

    8. Ana Kumamoto says:

      Opacity of right hilum.

    9. Shekhar says:

      Aneurysm of descending aorta with right hilar opacity. Lymph node more likely.

    10. Beyhan says:

      Descendan thoracic sırta aneurism and right hilar opacity( Lap?)

    11. Diana Baptista says:

      Right parahiliar adenopathy

    12. Aleksandar says:

      Blunted phrenicocostal sinuses due to pleural effusion. Fusiformly dilated descending aorta. Homogenous round opacity in right hilum, possibly adenopathy.

    13. genchi bari italia says:

      …senza una LL non ci si può sbilanciare…..potrebbe essere un esito adenopatico come da m. di Castleman…aspettiamo la TC del venerdì….un caro saluto da Bari….

    14. Bujar says:

      Any right pleuritic chest pain

    15. Bujar says:

      (I apologise prof.Jose i wos wery busy -i’m on duty in regional hospital) suspect for discret air -fluid level ( a littl amount of the likid) right subdiafragmal.Anyway i will do a chest x ray in expiration.
      On the other hand radiography is asimetrical,therefore no mediastinal structures are entirely clear – x ray anatomy.
      Solitary pulmonary nodul and blunted phcostal sinuses – my opinion is granuloma.

    16. María says:

      I got it! Buy my English is not as good as I though. I tried to post a report in English, buy I couldn´t find the words (or maybe I was concerned that I wrote it bad). Can I use Spanish in a next case?

    17. EIAEAMRO says:

      Right hilarious mass
      Tracheal shadow not continuous

    18. Pop Adrian says:

      You haven’t confirmed or denied pleural effusions. Could you clear that up for us? Love your posts. Thank you!