Caceres’ Corner Case 176 (Update: Solution!)

Dear Friends,

Today, I am showing radiographs of a 68-year-old man with pain in the chest. 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


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    Jan 2018
    DISCUSSION 8 Comments

    8 Responses to : Caceres’ Corner Case 176 (Update: Solution!)

    1. Mk says:

      Good morning and happy 2018!

      The x-ray is slighly rotated to the left side but there is an increased density in the left apical region (pancoast?). The superior vein cava is more visible than usual because of the slighly rotation.

    2. Coffee says:

      There is focal mass-like opacity at left apical lung.
      And there is suspected increased opacity at LLL zone, retrocardiac region.
      Futher CT is helpful.

    3. Ggy says:

      Left upper lobe atelectasis (triangular homogeneous opacity in the apical region on lateral view) probably due to left sided apical space occupying lesion. Maybe slightly elevated left diaphragm and hilum.

      • Jose Caceres says:

        I believe that the triangular opacity is due to the soft tissues of the axilla. If it were real it would be very visible in the PA view.

    4. Vincenzo says:

      Vincent, new entry.
      Confirm Mk evidence

    5. Amago says:

      Increased density in the left apex, if he has pain my first option is a Pancoast.

    6. ZHW says:

      Not convinced there is malignant pathology at the left apex – it looks bony ? osteophyte.
      there is subtle consolidation in the left lower lobe on the lateral best seen on the lateral. This could be the cause of the pain.

      • Jose Caceres says:

        Agree with you it looks bony, but very large to be an osteophyte.
        The subtle opacity in the lateral view is due to superposition of lower lobe vessels. It is a very difficult area to interpret.