Chest x-rays

 

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CLINICAL DETAILS:

SLE. Pulmonary hypertension

CHEST:

There is prominence of both hilum due to enlargement of pulmonary vessels. There is blunting of both costophrenic angles which could represent small pleural effusion/pleural reaction. There is pruning of peripheral pulmonary vessels findings are consistent with pulmonary hypertension.

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CLINICAL DETAILS:

Carcinoid with effusion. Progress.

CHEST:

There is a left pleural. There is no pneumothorax. Persistent bilateral hilar and perihilar lymphadenopathy is present.

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CLINICAL DETAILS:

Ca pancreas 

CHEST:

Normal.

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CLINICAL DETAILS 

Right lower lobe collapse. Haemoptysis. ?Bronchogenic carcinoma 

CHEST:

There is volume loss in the right lower lobe. In addition there is a relatively well-defined rounded soft tissue density in the posterobasal segment of the right lower lobe. On the lateral film air bronchograms appear to be projected within this soft tissue opacity. In addition the right hilum is slightly bulky and there is increased soft tissue around the intermediate stem bronchus. There is continuing linear atelectasis at the right base. No other new features.

COMMENT:

Although the soft tissue opacity in the right lower lobe may be residual collapse/consolidation, in conjunction with the appearance at the hilum this is highly suspicious of bronchogenic carcinoma and a chest CT is recommended.

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CLINICAL DETAILS:

Previous left and right adenocarcinoma of the lung. Now persistent pleural effusion on the left.

CHEST:

A large left sided pleural effusion noted. In addition there is collapse/consolidation of the left upper zone. Surgical clips noted over the right suprahilar region. Diffuse nodular shadowing present throughout both lungs. Pulmonary vasculature normal. No evidence of obvious bony metastatic disease.

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CLINICAL DETAILS:

Right pneumothorax and pleural effusion. Asymptomatic.

CHEST:

There is a right sided hydropneumothorax with extensive collapse of the right lung although the middle lobe appears tethered to a small area of pleural thickening.The left lung is clear. I note that the patient has recently been given oral contrast media. There is no evidence of aspiration of the contrast media.

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CLINICAL DETAILS:

Right pneumothorax and pleural effusion. Asymptomatic.

CHEST:

There is a right sided hydropneumothorax with extensive collapse of the right lung although the middle lobe appears tethered to a small area of pleural thickening.The left lung is clear. I note that the patient has recently been given oral contrast media. There is no evidence of aspiration of the contrast media.

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CLINICAL DETAILS:

Repositioned chest tube.

CHEST:

The tube has been withdrawn slightly and now the tip lies on a convexity of the hemidiaphragm. There is only a small amount of pleural fluid remaining. There is patchy plate atelectasis at the left base. There is a small right pleural effusion and patchy right lower lobe atelectasis.

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CLINICAL DETAILS:

Left sided chest pain longstanding. Recent chest infection and malaise with dull left base with decreased b.s ? effusion.

CHEST:

There is a large left sided pleural effusion. There is associated collapse of the left lower lobe, the left upper zone and right lung and pleural space are clear.

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CLINICAL DETAILS:

Large persistent left pleural effusion. CCF. RA. Post pneumonia.

CHEST + LATERAL: (AP SITTING)

Despite the projection the transcardiac diameter is increased. Pulmonary vasculature normal. Large left-sided pleural effusion. Underlying consolidation of the lingula and left lower lobe is suspected.

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CLINICAL DETAILS:

Dyspnoea. Raised JVP. ? pathology.

CHEST:

There is a soft tissue density adjacent to the left mediastinal contour. This does not obliterate the aortic arch or descending aorta suggesting it is anteriorly based. There are some areas of calcification within it and some poorly defined edges. On the right handside a similar soft tissue mass appears to exist. This appears to obliterate the interface produced by the azygos vein again suggesting it is anterior. The lungs are essentially clear. On the lateral radiograph it is difficult to truly ascertain the position, however the anterior/superior cardiac window which should normally be clear is not, suggesting the mass lies within there.

COMMENT;

In view of the history of dyspnoea (? stridor) and raised JVP an anterior mediastinal mass with compression of the superior vena cava is suspected in view of this we would recommend a CT scan.

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CLINICAL DETAILS 

Moderately severe asthma. Pre op.

CHEST:

The lungs are markedly hyper-inflated. No collapase or consolidation is present. The heart size is normal.

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CLINICAL DETAILS:

Retroviral disease. Fever. Dull right base ? Effusion.

CHEST:

AP erect film.

The abdominal portacath obscures the left costophrenic angle. There is no right pleural fluid. There is continuing bilateral perihilar patchy airspace shadowing extending into the lower zones medially. There is a suggestion of this coalescing into nodules bilaterally raising the possibility of underlying fungal infection or possibly TB.

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CLINICAL DETAILS:

Retroviral illness. ?Pulmonary KS.

CHEST:

There is ill-defined added opacity in the perihilar regions and at the bases which appears to be predominantly peribronchial in distribution with relative sparing of the peripheries and upper zones. The added opacity is ill-defined but appears somewhat nodular. The left hilum is bulky, raising the possibility of added lymphadenopathy. The pleural spaces remain clear.

INTERPRETATION:

The distribution of abnormality and pattern of involvement would be consistent with Kaposi's sarcoma of the lungs, the differential would include lymphoma or atypical infection such as tuberculosis or fungal infections.

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CLINICAL DETAILS:

CRF on HD.

CHEST:

The Hickman inserted by a LIJV approach, remains unchanged in position and the tip is projected over the SVC. The pleural spaces and lung fields remain clear. The hilar shadows, mediastinum and cardiac shadow are within normal limits.

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CLINICAL DETAILS:

Coughing up blood. Smoker.

CHEST:

There is evidence of extensive peribronchial consolidation at the posterior basal and lateral basal segments of the left lower lobe. This is certainly compatible with infection. A follow-up is strongly recommended after treatment in view of the haemoptysis.

The lung fields are otherwise markedly hyperinflated, the heart size is normal and the thoracic aorta markedly unfolded and calcified.

IMPRESSION:

Left lower lobe infection. A follow-up is strongly recommended.

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CLINICAL DETAILS:

Asthma. Cough. Some sputum. Localised chest pain worse on coughing.

CHEST + LATERAL:

Poor inspiration. There is some peribronchial nodular shadowing in both lower lobes and generally around the left hilum. This could be partly explained by a suboptimal inspiration, but I am suspicious of a moderate diffused pneumonic process.

A follow-up chest x-ray is advised. Heart size cannot accurately be assessed.

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CLINICAL DETAILS:

Renal failure. Non insulin dependant diabetes. Ischaemic heart disease. SOB. Ex-smoker. Recent MI.

CHEST:

The left hemidiaphragm is raised, however the apex of it is rather medial and the possibility of a subpulmonic pleural effusion should be considered rather than simple elevation of the hemidiaphragm.

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CLINICAL DETAILS:

Haemoptysis.

CHEST:

Both hila are enlarged with a lobulated outline. There is bilateral reticulonodular shadowing, most prominent in the mid and lower zones, particularly on the left. There is relative sparing of the upper zones. Heart size is normal.

INTERPRETATION:

Bilar lymphadenopathy with interstitial changes in the mid and lower zones. Appearances are compatible with sarcoidosis.

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CLINICAL DETAILS:

Right thoracic mesothelioma. Non-smoker. Previous thoracotomy. Clinically well.

CHEST + LATERAL:

There is encacement of the right lung by a soft tissue density, with associated right hemithoracic volume loss, and rib crowding. The underlying lung appears to have decreased aeration These changes are consistent with the history of mesothelioma plus/minus post-operative change. There appears to be right lower lobe collapse/consolidation. The left lung is clear.

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CLINICAL DETAILS:

Renal Ca.

CHEST:

The heart size is normal. There is a large lobulated opacity situated in the lateral aspect of the left lower chest which may represent either an intrapulmonary secondary or a pleural secondary. Follow-up films together with a left lateral are suggested or a CT. A little fluid is present in both costophrenic angles.

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CLINICAL DETAILS:

Renal cell carcinoma with secondary deposits.

CHEST:

There are left pleural deposits. The left hilar region is enlarged. There is some collapse posteriorly in the left lower lobe together with an area of linear atelectasis at the right base.

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CLINICAL DETAILS:

History of hypertension and night sweats.

CHEST:

There are calcific densities projected over the right apex of the lung which would be consistant with old TB granulomata. The rest of the chest film is normal.