Los Casos de Dr. Pepe – Caso de tórax 20 (Resuelto)


Hola amigos: Siento deciros que hoy presento el último caso de tórax. El año que viene no estaré con vosotros porque he decidido volver con mi amigo José Cáceres, que necesita ayuda para su blog. Os agradezco a todos vuestra colaboración y espero que nos encontremos de nuevo en el blog en inglés de la ESR. También quiero agradecer al Dr. Josep Mata su colaboración inestimable en muchos de los casos de este blog.
Las radiografías de hoy pertenecen a un hombre de 72 años con hemoptisis.

¿Cuál sería vuestro diagnóstico?

Podéis dar vuestra opinión hasta el viernes, día en el que se publicará la solución.

lateral tórax
tórax PA

Hallazgos: La radiografía PA muestra un aumento de densidad del hilio izquierdo (A, flecha). En la placa lateral se observa que el aparente hilio denso se debe a superposición de una masa retrohiliar irregular (B, flecha):


TC sagital y axial confirman la presencia de la masa (C-D, flechas), con un alto SUV en el PET-TAC (E, flecha).

Diagnóstico final: Carcinoma primario de pulmón.


Teaching point: Es importante recordar que el hilio denso puede no deberse a enfermedad intrínseca hiliar sino a una lesión pulmonar superpuesta.

Jun 2015
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