Dr. Pepe’s Diploma Casebook: Case 101 – A painless approach to interpretation (Chapter 8) – SOLVED!

Dear Friends,

Today I am presenting the last chapter of the Painless Approach to Interpretation. Showing chest radiographs taken during an annual check-up of a 70-year-old man.

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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    9 Responses to : Dr. Pepe’s Diploma Casebook: Case 101 – A painless approach to interpretation (Chapter 8) – SOLVED!

    1. MK says:

      The lateral view shows a high density lesion proyected over the vertebral body with an anterior well defined margin (posterior mediastinum). I cant find it in the PA view. I think it correspond to a vertebral lesion.
      In the PA view the trachea is slighly displaced to the right side.

    2. Jose Caceres says:

      In older persons it is normal to have the trachea displaced to the right by the elongated aorta

    3. BS says:

      The PA view shows an tubular infracarinal lucency which communicates with the carina,displacing the left main bronchus.this can also be seen on the lateral view, reaching the heart contour. Probably a subcarinal air cyst communicating with the carina.

    4. Pepita says:

      Sclerotic lesion of Th vertebral body, prostatic Ca meta?
      Widening of the right upper mediastinum- right paratracheal, lymphadenopathy? Vascular structures? Retrosternal mass?

    5. ZHW says:

      Sclerotic vertebra – given age concerning for metastasis most likely prostate (I would compare to old films and make sure not old and benign). The left main bronchus has a slightly vertical orientation and the left upper zone looks a more lucent compared to the right but I cannot see features of left lower lobe collapse so I’d ignore this and just call vertebral lesion and suggest bone scan / PSA level.

    6. genchi bari italia says:

      ….il polmone di sx è iperlucente, , da patologia del bronco lobare che appare improntato anteriormente e leggermente dislocato posteriormente( ?)…l’ilo vascolare mi sembra ipoplasico….anomalia vascolare ? Comunque vada è bello sfidarti !

    7. Mahmoud says:

      Lateral view shows rounded opacity projected over a mid thoracic vertebra
      Likely represents pleural bases posterior pulmonary mass.
      It’s not clearly seen on PA view

    8. Mariam says:

      In lateral and AP view in the left lung there is density lesion.

    9. Sunita says:

      Thank You Dr.Pepe