Case 62 Lung Cancer With Lymphangitis Carcinomatosis

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The CXR shows a left upper lobe mass and mid-zone infiltrates with a normal heart size. In addition, there are Kerley B lines (Fig. 62.2) in the periphery of the left mid zone, suggestive of lymphatic distension. These features are consistent with the advanced lung cancer metastasizing to the lymphatics. The prognosis is extremely poor.

Carcinomatosis Pleural

Case 63. This 24-year-old female was asymptomatic. Six months ago, she presented with pneumonia-like symptoms of cough, fever, and purulent sputum. Describe her CXR (Fig. 63.1).

Pneumonic Infiltrate
Fig. 63.2

CASE 63 BRONCHIOLITIS OBLITERANS ORGANIZING PNEUMONIA (BOOP)

The CXR shows a right lower lobe infiltrate which demonstrates some air bron-chograms on CT (Fig. 63.2). In addition, there seems to be a beady appearance to the infiltrates. Pneumonic changes on CXR typically resolve within three months. She subsequently underwent a bronchoscopy and transbronchial lung biopsy which showed BOOP. This is an idiosyncratic reaction sometimes seen in association with drugs, chemical inhalation, connective tissue disease, and various infections. This is usually very steroid-responsive.

Chemical Inhalation
Fig. 64.1

Case 64. This elderly male had hemoptysis and loss of weight over the past three months. His CXR is shown (Fig. 64.1).

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