The CXR shows a mass in the right upper zone with a pleural effusion, suggestive of advanced lung cancer. The lower end of the tracheal air column also shows narrowing, indicating involvement by the cancer. Lung cancer is the commonest cause of malignant pleural effusion and is usually secondary to smoking. Squamous cell and small cell lung cancer tend to involve the central airways, the latter often associated with mediastinal lymphadenopathy. Adenocarcinoma of the lung tends to present as peripheral nodules.
Case 41. This middle-aged male presented with fever, productive cough, and shortness of breath of two weeks' duration. This was his CXR (Fig. 41.1).
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