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LEFT sided lower zone pneumothorax in patient with COPD.
Note hyperinflated lungs and coarse lung markings
Intussusception of ileum and caecum.
CT shows a long segment intussusception in the right upperquadrant, which is thought to involve the ileum and caecum.
Note inferior portion of renal cyst visible posterior to intussusception
high signal in gallbladder, in keeping with clinical picture of cholecystitis secondary to gallstone
Pericardial effusion, pleural effusion,
Mediastinal drains in situ. Pericardial effusion and bilateral pleural effusions with collapse/consolidation of the adjacent lung.
Lung cancer affecting left upper lobe, mediastinal lymphadenopathy and left sided pleural effusion with patchy consolidation.
Gross cardiomegally with dilated right atrium and upper lobe blood diversion.
Hyperinflated, large volume lungs with a narrow mediastinum and flat diaphragms.
Lungs are also hyperlucent, typical of COPD
Marked cardiomegally - main differentials are of pericardial effusion or cardiomyopathy.
If this was to be a new finding an urgent echocardiogram would bewarranted due to the risk of tamponade.
Also of note is a soft tissue density in the right paratracheal region. This could be due to thyroid goitre or be vascular. However, given prior history of breast cancer, recurrence
Malignant melanoma showing the classical cannonball metastasis
AP CXR shows multiple pulmonary nodules of varying sizes.
Pneumonia - upper lobe consolidation
It should be noted that this CT scan shows a rather expiratory scan (note collapse of bronchi).
There is a dense consolidation of the right upper and lower lobes with some adjacent ground glass consolidation.
There is a small right pleural effusion. Tiny left pleural effusion with adjacent atelectasis.
Right sided consolidation + pleural effusion. Note also important hardware: endotracheal tube, right sided central venous catheter and ECG leads.
Lesion in the left cerebellar hemisphere with mass effect and surrounding oedema.
Pigtail chest drain projected over RIGHT lower zone. Pleural thickening/effusion and patchy consolidation in RIGHT lower lobe in keeping with resolving empyema
RIGHT upper lobe consolidation
Erect CXR, with good inspiration.
Bilateral upper lobe consolidation with evidence of cavitation in the left upper lobe.
Rounded opacity in the LEFT upper zone.
History and previous CT suggest that the opacity is likely to be a metastasis from a bladder tumour.
Large rounded pulmonary metastases are sometimes termed 'cannon ball metastases'. If the mass is solitary, primary lung cancer is the other main differential.
Bronchogenic carcinoma of left upper lobe
Routine CXR in long term smoker with chronic cough. Focal density is visible in the left mid zone, given history potentially suspicious nature - CT scan requested to elicit nature of density, confirmed spiculated 2.9cm mass, in keeping with bronchogenic Ca
Fracture of the RIGHT Fibula - not visible, Vessel calcification seen in posterior tibial artery
# right fibula (not seen on this lateral film) and vessel calcification.
Vessel calcification should prompt assessment of vascular risk factors, especially diabetes.
CT showed large spinal tumour at T7 causing cord compression
Cavitation lesion in RIGHT lung
CXR demonstrating RIGHT upper zone shadowing, with the appearance of a cavitating lesion, most likely an infectious consolidation - TB is being investigated, and malignancy cannot be ruled out.
Marked ground glass attenuation bilaterally. There is no evidence of COPD, bronchiectasis or lung fibrosis. Lung fields show extensive patchy areas of ground glass haziness with some centrilobular nodularity. There is early traction bronchiectasis in the periphery. There are some areas of air trapping.
ADVANCED RIGHT UPPER LOBE LUNG CANCER
Right Upper lobe mass in hilar region.
Dextrocardia situs inversus - Note that this is not simply dextrocardia, where the heart alone is found to be further displaced to the right of thorax than normal.
This is situs inversus, therefore all major structures have been transposed through the sagittal plane - note the gastric bubble on the RIGHT. The liver will also be located on the LEFT
For interest, the normal anatomical
Fluid overload and pulmonary odema with concomitant cardiomegally
The heart is enlarged. There is bilateral perihilar linear shadowing representing intersititial oedema. There is also upper lobe venous blood diversion. There is also thickening of the right horizontol fissure. Features are in keeping with pulmonary oedema.
INTERTHORACIC STOMACH POST OESOPHAGECTOMY
INTERTHORACIC STOMACH
RIGHT sided pneumothorax
Four calcified fibroids
\"Cannon Ball\" shadows on CXR
Extensive "Cannon ball" shadows suggesting metastatic malignancy across both lung fields
\"Saddle thrombus\" in Pulmonary artery
Large "Saddle Pulmonary Embolism".
\" thumb-printing \" sign on AXR
"Thumb-printing " sign which suggests bowel wall oedema from fulminant colitis.
Mutliple, widespread Liver Metastases
Selected axial image from a contrasted CT examination demonstrates mulitple, widespread low attenuation lesions throughout the liver consistent with liver metastases.
The primary malignancy is in sigmoid colon (Not visualised on this image)
Bronchiolitis and Pneumothorax
Due to poor clinical picture a preliminary diagnosis of bronchiolitis was made.
X-ray was performed after admission showing a RIGHT pneumothorax of RIGHT upper lobe, with minimal compression of Middle and Lower lobes.
XR Cervical spine - an acute flexion deformity is visbile at C2. The posterior elements of C2 appear to be missing due to pathological fracture.
"Kidney shaped" gas bubble of distended caecum, with evidence of complete bowel obstruction due to evidence of little gas in rest of lower GI tract
Found in usual location to the left of mid-line
No fluid level visible
Large bowel obstruction or pseudoobstruction (no further CT scan done to distinguish)
Generalised gaseous distention of the large and small bowel. No gas in the rectum.
Fractured rib, left sides pneumothorax and haemothorax to left lung.
Fracture of 7th rib
Small pneumothorax and haemothorax to left lung with loss of costophrenic angle.
Visible artifact - nasal cannulae NOT chest drain
Emphysema - non-infective exacerbation
PA film
midline sternotomy noted.
Emphysematous changes seen in both lung fields in keeping with COPD
No focal active lung lesion seen
