Case 34 Bronchiectasis Affecting Both Lower Lobes

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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.

Cxr Bronchiectasis Ring Shadows

Case 35. This middle-aged female smoker was asymptomatic. Describe the CXR abnormality (Fig. 35.1).

Solitary Lung Nodule Benign Cxr

CASE 35 SOLITARY PULMONARY NODULE (SPN) DUE TO PRIMARY LUNG CANCER

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).

Bilateral Cervical Strain
Fig. 36.1

Case 36. This middle-aged male had loss of weight and bilateral cervical lymphadenopathy. His CXR is shown (Fig. 36.1).

Hamartoma Cxr

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Responses

  • hagos yonas
    What part of the airway does bronchiectasis affect?
    8 years ago
  • lukas
    What is a calcified lung nodule?
    7 years ago

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