X-Ray Chest: Carcinoma Lung

1. Dept of General Medicine
Stanley Medical College
Image of the week…
Prof.Dr.Magesh Kumar’Unit
Dr.Bala murugan

2. 62yr old male chronic smoker has admitted with
c/o
dysphagia for solids –2 months
Difficulty in breathing—1month
Engorged veins over the chest—2weeks
Congestion over the face and eyelids—5days
X-ray was taken…

5. •X-ray chest PA view, slight malrotation
present
•Dense opacity in right upper lobe
•Pulling of minor fissure upwards
•Lobulated ? mass lesion in right perihilar
region
•Right cardiac silhoutte sign present
•Obliteration right CPA
•scoliosis in the lower dorsal spine

12. CT Chest
•Right upper lobe homogenous dense opacity
is seen
•Pleural effusion is seen.
•Erosion of ribs present.
•Lobulated mediastinal lymph nodes.

13. X-ray manifestations of Ca Lung
•Hilar enlargement:
may be due to primary tumor or lymph node
metastasis
best demonstrated by CT / MRI
Airway Obstuction:
collapse of lung distal to tumor
may lead to consolidation
but air bronchograms usually absent
except in Alveolar cell Ca.

14. •Peripheral mass lesions:
Points to favor benign lesions
small size
well defined lesion
satellite opacities
diffuse or central calcification
very long doubling time
But biopsy is needed to confirm.

15. •Cavitation
Thick walled irregular nodular inner margin with
air fluid level

16. Primary tumor in the
left hilum.
Lytic lesion the Right
rib

17. A large round soft
tissue mass in righr
apex with blunting
of costophernic
angle

18. Same person showing a x-ray taken 6 months after the first
one. Tumor has enlarged caviated and bulging in aorto-
pulmonary window indicating lymph node enlargement

19. Enlargement of the
left hilum due to
lymph adenopathy
Primary tumor not
visible

20. Soft tissue nodule in
left mid zone with
hilar prominence

21. Collapse of entire
lung