Caceres’ Corner Case 153 (Update: Solution)

Dear Friends,

This week we are showing a relaxing case. Images belong to a 64-year-old man with a cough and fever. What do you see?

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

Click here for the answer to case #153

Be Sociable, Share!
    Feb 2017
    DISCUSSION 23 Comments

    23 Responses to : Caceres’ Corner Case 153 (Update: Solution)

    1. MK says:

      Good morning!!

      In the AP view there is a slightly right displacement of the trachea and an amputation of the principal right bronchus. There is an increased density with smooth margins over the minor fisure, probably an atelectasis.
      In the lateral view there is an increased density in the right hilum.

      Hiliar lesion (adenopathy, tumor…) with secundary atelectasis?

    2. Oleg Semko says:

      The medial lobe is colapsed. It is right medial lobe atelectasis.

      • Agreed…
        Additionaly there’a a large rounded lypmh node in the right hilum indicating lung cancer being the cause of the collapse.

      • Jose Caceres says:

        The lung disease is above the minor fissure, meaning RUL afectation. If it were RML, disease would be below the fissure. Sorry to disagree 😉

    3. Mahmoud says:

      Fluid in minor fissure with adjacent pneumonia consolidation.

    4. Sheriff says:

      Lost of volume of the right upper lobe with enlargment and increased density of the right hilum and segmantari atelectasis. In the lateral view we can add the finding of a probably subcarinal adenopathy.
      First treat the acute symptoms (atb…) and order a control plain in a few weeks to check a radiological improvement, if it doesn’t consider

    5. Rv says:

      Fluid along the horizontal fissure

    6. Quique says:

      Golden sign

    7. Irina says:

      Fluid in the minor fissure.

      • Jose Caceres says:

        Fluid in the fissure usually have a convex border. This one is concave. Sorry to disagree 😉

    8. Olena says:

      On the right there is homogeneous wide horizontal linear opacity well marginated localized on the level of projection of minor fissure – suggestion of pleural inflammatory reaction, with probably restricted effusion in fissure.
      Paying attention the decreased attenuation in subpleural region of the vessel architecture in the right upper lobe due to apical pleural thickening.
      Doubled shadow of the right diaphragm due to its relaxation

      On lateral view there is increased transparency in retrosternal space due to lung herniation and opacity in the lower anterior mediastinum suggestion pleura thickening/infiltration

      Conclusion: suggestion pleural thickening and effusion in minor fissure, periscisuritis

    9. genchi Bari italia says:

      ….lipoma pleurico…..Bari in ripresa…..riasaliamo ai piani alti….Non ti avevo dimenticato…

    10. Lola la Piconera says:

      Atelectasis of the anterior segment of the right upper lobe. If persistent it is needed to rule out endobronchial lesion such as a tumour – neuroendocrine?- or other causes – benign bronchial stenoses secondary to chronic infection/Tb?, foreing body in an adult? CT will help

    11. Vivi says:

      Hi! I cannot clearly see the continuation of the roght bronchus. So I believe there is golden sign associated with right hilum opacity (endobrochial lesion ?)and severar pycnotic-atelectatic elements of RUL. Let’s start with a CT.

    12. sht says:

      Atelectasis anterior segment right upper lobe.
      Hilar opacity – ?LN ?mass

    13. Don says:

      right middle lobe collapse

    14. Sunita says:

      central mass with partial segmental collapse of anterior segment of right upper lobe

    15. tr says:

      anterior segment RUL collapse with right hilar mass.