Chest X-Ray breakdown: assessing the hilar regions скачать в хорошем качестве

Chest X-Ray breakdown: assessing the hilar regions

A female smoker in her 50s presents with a few week history of cough. What does the Chest X-Ray show? ———————————————————————— LUNG CANCER AND METASTASES 👨🏽‍💻This is a tricky X-Ray with some subtle findings: 1️⃣Left hilum: compare the two hilar regions - the density of the left is increased compared with the right. Looking closely you can just make out a circular structure on the left - small circular densities are ok and can represent end on vessels but larger ‘lumps’ like this can represent lymph nodes or tumour. Remember a frontal X-Ray is a 2D representation of a 3D structure so an abnormality at the hilum may actually be in front of the hilum as it is here - the abnormal hilum actually relates to a left upper lobe nodule 2️⃣ Don’t forget to look behind the heart and check left with right - here there is a nodule on the left confirmed with CT 3️⃣ The regions just above and below the hilum are common places for missed lesions - here there is a subtle nodule above the right hilum. This would have been a tough ask if this was the only abnormality on the film but with the other abnormalities this has to be considered suspicious Putting everything together here the differential includes 1️⃣Lung cancer and associated tumour nodules 2️⃣Metastases from a separate primary A CT guided biopsy here confirmed number 1️⃣ The lesson here is to really piece apart the hilar regions on every film you look at 🔻@theradiologistpage ✅Patient consent obtained ——- #theradiologist #radiology #radiologist #physician #physicianassistant #medicine #medstudent #medicalstudent #medschool #medicalschool #radtech #whitecoat #mri #medical #radiography #radiologystudent #doctor #medicalstudents #interventionalradiology #surgeon #medic #frcr #anatomy #usmle #medlife #exams #premed