The CXR shows infiltrates especially in the right middle lobe and the left lower lobe. The ring shadows and tramlines indicate the presence of dilated and thickened airways. The CXR findings were noted a few years previously indicating its chronicity. The accepted modality for the diagnosis of bronchiectasis is a highresolution CT Thorax which demonstrates these dilated airways in the left lower lobe (Fig. 34.2) using very thin (1-2 mm) slices. Bronchography is now seldom used.
Case 35. This middle-aged female smoker was asymptomatic. Describe the CXR abnormality (Fig. 35.1).
The CXR shows a 1.5 cm solitary pulmonary nodule in the left upper lobe (Fig. 35.2). An SPN is described as a single nodule (less than 4 cm) surrounded by normal lung parenchyma. The differential diagnoses for SPN include pseudo nodules (e.g. skin tags, nipple shadows, and bone lesions), primary lung cancer, solitary metastases, granulomas, arteriovenous malformations, pseudo tumors, and hamartomas. In this patient, the CXR a year ago did not demonstrate the shadow. CT (Fig. 35.3) also demonstrates the nodule to be non-calcified and the margins show spiculation making the nodule highly suspicious for malignancy. Thoracotomy and lung biopsy showed primary Stage 1 lung cancer (adenocarci-noma).
Case 36. This middle-aged male had loss of weight and bilateral cervical lymphadenopathy. His CXR is shown (Fig. 36.1).
Was this article helpful?
Quit smoking for good! Stop your bad habits for good, learn to cope with the addiction of cigarettes and how to curb cravings and begin a new life. You will never again have to leave a meeting and find a place outside to smoke, losing valuable time. This is the key to your freedom from addiction, take the first step!