Caceres’ Corner Case 77 (Update: Solution)


Dear Friends,

This week I am presenting radiographs of a 78-year-old male with haemoptysis. Have a look at the images below and leave us your thoughts and diagnosis in the comments section. The answer will be added on Friday.


1. Hydropneumothorax in minor fissure
2. Tuberculosis
3. Carcinoma
4. None of the above

78-year-old male, PA chest

78-year-old male, PA chest

78-year-old male, lateral chest

78-year-old male, lateral chest

Click here for the answer to case #77

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    Oct 2013
    DISCUSSION 17 Comments

    17 Responses to : Caceres’ Corner Case 77 (Update: Solution)

    1. genchi bari italia says:

      La cavità, con livello idroaereo ha sede intrapolmonare( si esclude il versamento pleurico saccato).Le pareti della cavità sono regolari e sottili( si esclude un CR-cistico).Non immagini adenopatiche ilo-mediastinic he( si esclude TBC). Potrebbe essere, in ragione dell’emottisi, un pneumatocele, post-polmonitico.

    2. DrD says:

      None of the above.May be Echinococcus cyst….

    3. gus says:

      I think is more than one cavities with and with out air fluid levels. Pulmonary cavities may be the result of malignancy, infection, inflammation or be congenital
      The frontal chest xray shows mild hyperinflation, and a coarse pattern in the lower lung fields consisting of reticular interstitial markings and central thin wall ring shadows with and with out air fluid levels suggesting cysts.
      Apical pleural thickening.
      I can’t observe mediastinal lymph nodes.
      i think the cysts is bronchiectasis.

    4. Bahnassy says:

      None of the looks an intrapulomary thin walled ruptured cyst (DD:hydatid,bronchogenic cyst )

    5. Maria says:

      There is upwards position of right hilum with atelectatic changes of middle lobe. There is also some obliteration of retrosternal space. There is thickening of interstitial space of RUL. I vote for carcinoma.

    6. Marcy says:

      There is loss of volume of the right hemithorax, indicating that a cronic process could co-exist. Moreover I see some round lucent structures in the RUL, that could represent bronchiectasis , additionaly there are at least to cystic lesions which contains air-fluid level in the upper lobe, contacting the minnor cisure , in my opinion due do bronchiectasis in the setting of a TB infection (because the location). As complication this patients could manifest with hemoptysis

      • Dr.Amutha says:

        cysts with airfluid level in rt parahilar region,
        ?complicated bullae / central bronchiectasis/ cavities

    7. Aida says:

      Non of the above , most likely Lymphangitic carcinomatosis .

    8. Aida says:

      Most likely Lymphangitic carcinomatosis .
      Non of the above

    9. Mila says:

      There is loss of volume of the right lung, with the fibrous changes in the RUL which pull up right hilum. The right apex is blurred. Two cysts with air-fluid level are also prezent in RUL near hilum. The heart siluette seems bigger. I vote for Tbc (coexisting with cardiac insuffitiency)

    10. Amira says:

      There’s right fissural effusion (at right transverse fissure)with an atelectatic band is seen superior to it at the middle lung zone. Left pleural capping at left lung apex is also seen. I would go for TB suggestion. However, I recommend further investigation to rule out possibility of pulmonary embolism as I can notice subtle lucency difference between both hemothoraces.

    11. Ricardo Macareno says:

      How difficult is the chest radiograph¡¡

    12. sameh khodair says:

      Encysted hydropneumothorax in the transverse fissure

    13. sameh khodair says:

      Encysted hydropneumothorax in the transverse fissure, i think so

    14. salah says:

      ruptured cyst with air-fluid level associated with fissural effusion. i vote for TB