A 73-year-old male smoker presented with hemoptysis, breathlessness, chest pain, and wheezing. A chest X-ray showed a homogeneous opacity measuring approximately 7 cm with spiculated margins in the left upper lung zone, suggestive of malignancy with mediastinal invasion. Central lung tumors commonly present as cough, breathlessness, hemoptysis, and wheezing.

1. X RAY OF THE WEEK PROF.S.SUNDAR UNIT

2. 73 Year old male admitted with c/o hemoptysis,breathlessness,chest pain and wheeze Smoker for 20 years

4. X RAY FINDINGS CHEST X RAY PA VIEW TAKEN IN FULL INSPIRATION ADEQUATELY PENETRATED SLIGHT ROTATION TO RIGHT TRACHEA SLIGHTLY DEVIATED TO THE RIGHT CARDIOPHRENIC AND COSTOPHRENIC ANGLES ARE FREE RIGHT LUNG FIELDS ARE CLEAR.LEFT LUNG FIELD SHOWS A HOMOGENOUS OPACITY WITH SPICULATED MARGINS IN THE UPPER ZONE CARDIAC SHADOW APPEARS NORMAL NO BONY ABNORMALITIES DETECTED BORDER OF DESCENDING AORTA IS WELL DEFINED WHEREAS THAT OF ARCH OF AORTA AND ORIGIN OF DESCENDING AORTA ARE ILL DEFINED

7. IMPRESSION HOMOGENOUS OPACITY OF ABOUT 7 CM IN DIMENSION WITH SPICULTAED MARGINS SUGGESTIVE IN FAVOUR OF MALIGNANCY WITH MEDIASTINAL INVASION

8. POINTS IN FAVOUR OF MALIGNANCY DIAMETER >6 CM SPICULTAED MARGIN INVASION OF MEDIASTINUM

9. CENTRAL IN LOCATION SMALL CELL CA.(74%) SQUAMOUS(64%) LARGE CELL CA.(42%) ADENO CA.(5%)

10. Symptoms in central growth Cough Breathlessness Hemoptysis Wheeze

11. CXR IN BRONCHOGENIC CA. MC PRESENTATION-PULMONARY PARENCHYMAL NODULE OR MASS When a central obstructing lesion is present , secondary signs such as lobar atelectasis or unresolving pneumonia might be present rather than visualization of the primary tumor Detection of presence of mediastinal and hilarlymphadenopathy, pleural effusion , involvement of bony thorax

12. Thank you