cxr: multiple cavities

16
CHEST SKIAGRAM FOR CHEST SKIAGRAM FOR DISCUSSION DISCUSSION DR AMUDHAN DR AMUDHAN PROF Dr E. DHANDAPANI ‘S PROF Dr E. DHANDAPANI ‘S UNIT UNIT

Upload: stanley-medical-college-department-of-medicine

Post on 11-May-2015

2.480 views

Category:

Health & Medicine


5 download

TRANSCRIPT

Page 1: CXR: Multiple Cavities

CHEST SKIAGRAM FOR CHEST SKIAGRAM FOR DISCUSSIONDISCUSSION

DR AMUDHANDR AMUDHAN

PROF Dr E. DHANDAPANI ‘S PROF Dr E. DHANDAPANI ‘S UNITUNIT

Page 2: CXR: Multiple Cavities
Page 3: CXR: Multiple Cavities

X-ray chest PA ViewX-ray chest PA View Properly positioned,good penetration with Properly positioned,good penetration with

full inspirationfull inspiration Trachea slightly to leftTrachea slightly to left Bony and Soft tissue shadow normalBony and Soft tissue shadow normal Costophrenic angle freeCostophrenic angle free Hyperinflation of lungHyperinflation of lung

Page 4: CXR: Multiple Cavities

Large cavity with surrounding Large cavity with surrounding emphysematous changes – upper & middle emphysematous changes – upper & middle zone with bronchiectatic changes –middle & zone with bronchiectatic changes –middle & lower zone of right hemithorax.lower zone of right hemithorax.

Multiple cavitatory lesions seen in upper Multiple cavitatory lesions seen in upper &middle zones with nonhomogenous opacity &middle zones with nonhomogenous opacity & bronchiectatic changes in lower zone of left & bronchiectatic changes in lower zone of left hemithorax. hemithorax.

Fibrosis of both upper lobesFibrosis of both upper lobes

Page 5: CXR: Multiple Cavities

Chest xray shows tracheal shift to leftChest xray shows tracheal shift to left Multiple cavitatory lesions bilaterallyMultiple cavitatory lesions bilaterally left hilum pulled upleft hilum pulled up Areas of consolidation left mid and Areas of consolidation left mid and

lowerzoneslowerzones Areas of bronchiectasisAreas of bronchiectasis Fibrosis both upper lobesFibrosis both upper lobes

Page 6: CXR: Multiple Cavities
Page 7: CXR: Multiple Cavities
Page 8: CXR: Multiple Cavities

CT THORAX CT THORAX Fibrotic changes B/L upper lobe with Fibrotic changes B/L upper lobe with

bronchiectatic changes in left lower lobebronchiectatic changes in left lower lobe Multiple cavitary lesion in both lungs. 11x3x5.4 Multiple cavitary lesion in both lungs. 11x3x5.4

cm sized thin walled cavity in right lung cm sized thin walled cavity in right lung 10 x 2 x4.2 cm cavity in left lung.10 x 2 x4.2 cm cavity in left lung. Patchy consolidation left lower lobe & B/L Patchy consolidation left lower lobe & B/L

Fibrosis with traction bronchieactasis in left Fibrosis with traction bronchieactasis in left upper lobe.upper lobe.

Page 9: CXR: Multiple Cavities

A cavity is defined as an air containing A cavity is defined as an air containing space within the lung surrounded by a space within the lung surrounded by a complete wall of 1mm or greater thicknesscomplete wall of 1mm or greater thickness

Thin walled cavity has a wall thickness of Thin walled cavity has a wall thickness of <1mm<1mm

Bulla is a type of thin walled cavityBulla is a type of thin walled cavity

Page 10: CXR: Multiple Cavities

FEATURES TO NOTED IN A FEATURES TO NOTED IN A CAVITYCAVITY

LocationLocation OutlineOutline Wall thicknessWall thickness Air fluid levelAir fluid level Contents of cavityContents of cavity Satellite lesionsSatellite lesions Surrounding lung parenchymaSurrounding lung parenchyma Intracavitary noduleIntracavitary nodule

Page 11: CXR: Multiple Cavities

LocationLocation

TB cavity usually upper zoneTB cavity usually upper zone Posterior segment of upper lobe &apical Posterior segment of upper lobe &apical

segment of lower lobesegment of lower lobe Site of lung abscesses following aspiration Site of lung abscesses following aspiration

depends on patients position at time of depends on patients position at time of aspiration usually lower zone and right sidedaspiration usually lower zone and right sided

Pulmonary infarcts are usually lowerzonePulmonary infarcts are usually lowerzone Pulmonary sequestration usually left side Pulmonary sequestration usually left side

lower zonelower zone

Page 12: CXR: Multiple Cavities

Thin walled cavityThin walled cavity

Bullae Bullae PneumatocelePneumatocele Inactive TB cavitiesInactive TB cavities Cystic bronchiectsisCystic bronchiectsis Hydatid cystsHydatid cysts Traumatic lung cystsTraumatic lung cysts

Page 13: CXR: Multiple Cavities

Thickwalled cavityThickwalled cavity

Acute abscessesAcute abscesses Squamous cell carcinomaSquamous cell carcinoma LymphomaLymphoma Most secondariesMost secondaries Wegener’s granulomatosisWegener’s granulomatosis Rheumatoid nodulesRheumatoid nodules

Page 14: CXR: Multiple Cavities

Satellite lesions are commonly seen in Satellite lesions are commonly seen in benign conditions like TBbenign conditions like TB

Fluid levels are seen in lung abscessFluid levels are seen in lung abscess

Fluid levels are uncommon in cavitating Fluid levels are uncommon in cavitating metastases & TB cavities metastases & TB cavities

Page 15: CXR: Multiple Cavities

Intracavitory nodulesIntracavitory nodules

AspergillomaAspergilloma Inspissated pusInspissated pus Blood clotsBlood clots Necrotic tumourNecrotic tumour CavernolithsCavernoliths Pulmonary gangrenePulmonary gangrene Ruptured hydatid cysts with daughter cysts Ruptured hydatid cysts with daughter cysts

floating within cavityfloating within cavity

Page 16: CXR: Multiple Cavities

THANK YOU THANK YOU