Dr. Pepe’s Diploma Casebook: Case 85 – SOLVED!


Dear Friends,

Today we are presenting chest radiographs of a 54-year-old man who has had a cough and left chest pain for the last two weeks. No fever.

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

1. Pleural effusion
2. Pleural effusion and mediastinal mass
3. Pleural effusion and pericardial defect
4. None of the above



Click here for the answer

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    16 Responses to : Dr. Pepe’s Diploma Casebook: Case 85 – SOLVED!

    1. Milos says:

      Probably no.3
      If is second picture raught lateral it should be fliped.

    2. Pasquale says:

      No. 2

    3. waleed says:

      Option 3

    4. Borsuk says:

      there is left pleural effusion. On lateral view left hila is enlarged – mayby mass. No mediastinal shift to left is seen – probably there is also some atelectasis on the left side.

    5. Katrina says:

      Left lower lobe collapse.

    6. JOSE says:

      Ans.: 3

      Left pleural effusion; contour abnormality of the left cardiac border, no mass seen, ? pericardial defect.

    7. genchi bari italia says:

      ..”.l’opacita'”ilare sx è in realtà il tronco della polmonare che nel difetto pericardico a sx, si associa a rotazione in senso orario della silhouette cardiaca….infatti non è visibile, per la rotazione l’arco aortico…..versamento pleurico…..la diagnosi però la fa la TAC….

    8. Mauro says:

      Maybe congenital absence of the left pericardium plus left pleural effusion and linear atelectases in the left lung. Number 3.

    9. rosetta says:

      no 1 may be associated with collaps of LLLobe

    10. Dr Pepe says:

      Dear friends, this time we are all mistaken, including myself, because I thought the the patient had a mediastinal tumor. CT demonstrated only pleural effusion.
      I am presenting this case to discuss how atypical presentation of free pleural fluid in the plain film may confuse you.