White bright shadow-homogenous.

1.

White bright shadow-homogenous.

Trachea is shifted to the affected area.

Dome of diaphragm is quite high.

We can see manifestation of tumours.

2.

Right upper lobe has decreased in size.

We can see some shift of the trachea.

Inferior border of lobe is sharp and concave.(normally it should be sharp along rib)

Shadow is quite homogenous(see arrow).

3.

Multiple nodules(shadows) are seen.- rather clear border.

4.

Many nodules are seen.

Some nodules have cavities inside.

Nodules can be different in size(large and small)

* in Metastatic disease, nodules are rather cleared.

5.

We can see an example of rounded shadow(see arrow).

Pheripheral tumours

Sometimes pheripheral with centralization.(tumour start at pheriphery and reach central borders).

Tumour may start at hilus.

6.

Tumour at early stage, small cavity.

Tumour growing to surrounding tissue.

Tumour disintegrates, increase permeability of bleeding- hemoptesis, pulse bleeding.

Margins are uncleared and uneven.

7.

Large tumour in lung.

Volume of lung has diminished.

No atelectasis.

Enlargement of hilus.

Regional metastasis.

8.

Mediastinum is enlarged.

Enlargement of lymph nodes.

Enlargement of hilus, of lymphnode—can think of enlargement of thymus(thymono)

No tumour seen.

Can be aortic aneurysm(shadow of aortic aneurysm)

9.

Example of PANCOAST TUMOURS.

Homogenous shadow with uneven margins seen.

Pancoast tumour can destroy ribs. It is adjacent to mediastinum.

Class discussion

10.

TOMOGRAPHY of RIGHT LUNG

We can say for sure that it is right lung as we can see homogenous shadow of liver.

Suspicious zone-see arrow.

We can’t see the ribs.

It is very difficult to judge.

No atelectasis.

Conclusion:

PHERIPHERAL TYPE OF CANCER.

11.

Xray is adequate.

PA view

Trachea is a bit deviated to the right.

Reflection of small transparency(bronchus, vessels)(red arrow)

Aneurysm of aorta(see black arrow)

Conclusion:

Maybe ANEURYSM or DILATION OF HEART VESSELS.

12.

Male

Inadequate xray.

We can see symmetrical patterns of the lungs.

It is like Water melon.

Conclusion:

Maybe it is PHERIPHERAL CANCER.

13.

Adequate xray

Shadow in right lung, lower lobe.

Shadows are uncleared.

No enlargement of lymph node.

Here it is difficult to differentiate between pneumonia and cancer.

We must perform antibiotic therapy to see changes. Then if residual structures present – we can suspect cancer.

Conclusion:

Maybe its FOCAL PNEUMONIA.

14.

We can see 2 shadows in right lung.

Shadows are in middle and lower lobe.

Shadows have clear borders.

Conclusion:

We can think about METASTASIS.

15.

Xray of RIGHT LATERAL view

Involvement of upper lobe.

Process takes place mainly in upper lobe.

Shadow is triangular in shape.

16.

TOMOGRAPHY.

We cant see the rib pattern well.

Shadow is of moderate intensity.

Borders are quite uneven.

Conclusion:

PHERIPHERAL CANCER.

17.

PA view:

We can see shift of mediastinum.

Maybe there’s enlargement of LV, the right side of heart is not shifted.

The neck seems to be bended to the left.-we cant say about deviation of trachea.

Hilus is not enlarged.

Shadow is in middle zone of left lung(see arrow)

Single shadow

Shadow is of moderate intensity, uneven borders and is not homogenous.

18.

Male 68 yrs. Inadequate xray due to absence of lower part of left lung. Xray is of poor quality.

PA view:

LEFT LUNG:

Shadow is in upper zone left lung.(black arrow)

Shadow is uncleared with eneven borders, infiltrating.

Pheripheral with centralization.

No enlargement of mediastinum.

A cavity with uneven margin and uneven thickness(red arrow) Upper border is dry part of cavity.

RIGHT lung:

No particular change

Conclusion:

NO ATELECTASIS.

PERIPHERAL CANCER WITH CENTRALISATION.

19.

PA view:

RIGHT LUNG

Shadow is localized in middle zone, right lung.

Trachea shifted to right.

Cartilages are ossified up to mediastinum.

Margins of shadow are even, well defined and clear.

LEFT LUNG:

Ossification of cartilages.

Conclusion:

It maybe a LUNG CYST.(cyst can be seen from lateral picture.UV-black in appearance)

Maybe TUMOUR GROWING FROM PLEURAL CAVITY- NOT FIXED AND MOVE..

*In case of tumours, if grow from chest wall,---it’ll destroy rib and it’ll fix to the chest wall and not able to move.

*some cyst can have some debris.
final diagnosis: Must pucture first.

20.

Male. Maybe xray was done after coughs.

We cant see the sinus costophrenicus and lung is inadequate.

We can see deviation of trachea to the left.

The whole LEFT LUNG is affected.

The heart maybe shifted to the left.

Shadow cover the whole lung, and shadow is homogenous.

Gas seen(see arrow)

Conclusion:

CENTRAL CANCER- 3^RD STAGE.

21.

PA view:

Enlargement of mediastinum.(9cm), a bit shifted to left.

Shadow homogenous, high intensity as there’s increase in opacity.

No enlargement of rib and dome of diaphragm close to round.

No atelectasis of upper lobe of left lung.

Conclusion:

Can be MEDIASTINAL CANCER or can be Hodgkin disease.

No atelectasis-confirm by fluoroscopy, to see how the lungs volume has changes.

To see mobility of mediastinum,

22.

Patient 60 yrs.

Shadow in lower zone left lung

Largest shadow:

Shadow-8cm.

Single shadow, round shape.

Shadow homogenous and borders even.

Level of diaphragm not seen, maybe due to pleural effusion.

Smallest shadow:

shadow uneven, multiple.

No shift of trachea

No enlargement of mediastinum.

Additional test must be done to prove it.

Дата добавления: 2015-11-05