L19 Radiology of the Thorax II Flashcards
Chest X-ray which bloops out everywhere
Lymphoma Lymphadenopathy
-goes into both pneumothoraxes
Neurofibroma
makes obtuse angles with rest of lung = coming from pleura or chest wall
invades into rib= weird soft tissue tumour or rising from vessels/nerves = the neurovascular bundle
-nerve is most likely to go wrong
What can lung disease’s effect?
- Pulmonary arteries e.g. vasculitis, Pulmonary Emboli
- Bronchi e.g. Asthma, Bronchitis, Bronchiectasis
- Lung Parenchyma e.g. Pneumonia, Lung cancer, Emphysema, Chronic Intersitial Lung disease
Lung disease’s effecting the Pulmonary arteries
-long flight Vasculitis (very rare) Pulmonary Emboli (sore leg, sitting down for ages, short of breath)
Lung disease’s effecting the Bronchi
Asthma
Bronchitis (smoking)
Bronchiectasis (smoking, viruses in cold conditions)
Lung disease’s effecting the Lung Parenchyma
-vivid in chest X-ray
-clinical conditions
Pneumonia
Lung cancer
Emphysema
Chronic Interstitial Lung Disease
Common Lung Abnormalities
Pneumonia Lung cancer- primary or metastases Trauma Pulmonary Emboli Cardiac Failure (CHF) Chronic Diffuse Lung Diseases
Important Questions if abnormality in the lungs (not mediastinum, pleura or chest wall)
- Pattern of Lung abnormality (to figure cause)
- Focal
- Multifocal
- Diffuse - Acute or Chronic
- history is crucial - Other clues e.g. cardiomegaly
Focal abnormlaity: Lung nodule
little white dust mark= centrally calcified nodule (satellite lesions)
Focal abnormality: Granuloma
granuloma= focal response of lung to fight off infection (TB) (histoplasmosis USA)
Focal abnormality: symptoms
poorly marginated. potentially pneumonia or cancer pacemaker= heart big well defined (not size)= more likely to appear with symptoms of cancer (haemoptosis and weight loss) -weight loss -short breath -productive cough -fever -haemoptosis -chest wall pain if hit pleura/ribs
Lobar collapse
What is blocking the bonchus??
-difficult to differentiate b.w pneumonia or cancer
-Pneumonia more likely to cause complete collapse of a lobe
-tumour in lower lobe bronchus= obstruction behind it
Sreatment: Straight to bronchoscopy or CT scan
-CT to look at liver and do staging + see where cancer is
Pneumonia vs cancer
History, Symptoms, time course (perfect–> queasy)
Exam
CXR appearance
Focal lesion
mass like opasity
-opaque to x-ray (better word than density as means blackness)
-fever? infectious symptoms?
- looks mass like so do follow up chest x-ray to make sure it goes away
-Lateral film = looks like a lobar process
-not total lobar collapse as oblique fissure isnt that high
= lobar pneumonia as good signs of co-infection
Lung total/partial collapse
Partial collapse in pneumonia:
lung isnt expanding well as is full of junk
Complete collapse: can happen in pneumonia but really hints to having tumour to cause the obstruction