Internal Medicine Weekly X-RAY Challenge
Instructions
Send us your answers by clicking the link below the image. On Friday, we will post the first correct answers by all-comers, residents, and students. Other answers of particular interest will also be posted as well as brief comments on the radiographic findings and the clinical problem.
Week 24-Clinical Description
51 year old male admitted to the hospital with shortness of breath. There is significant past medical history, but the plain CXR provides all the clues necessary.
Week 24-Image
Correct Answer:
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There are many radiographic findings. There is a haze over the left thorax. This haze is due to atelectasis of the left upper lobe. A port for IV injections is seen on the right side (white). This is a clue that chemotherapy has been used. The trachea is deviated to the left side (red) which is consistent with volume loss on the left. The lucency to the left of midline (blue) is due to herniation of the right lung across the midline. There is partial effacement of the left diaphragm (lavender) which is consistent with infiltrate or atelectasis of the left base. The lateral film clearly shows the atelectasis of the left upper lobe (blue). There is a loculated pleural effusion (red) which probably represents previous drainage of pleural fluid. The radiographic findings suggest endobronchial obstruction of the left upper lobe by lung cancer. The patient has stage IV lung cancer. Bronchoscopy to confirm the obstruction to the left upper lobe is pending. |
CONGRATULATIONS!
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.Robert DeMuro, TTUHSC PA student, correctly diagnosed atelectasis in the left lung. There will be a 1 week hiatus for vacation. A new challenge will be posted Monday, May 28. |