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 wheezeSmoker for 20 years

4. X RAY FINDINGSCHEST X RAY PA VIEW TAKEN IN FULL INSPIRATION ADEQUATELY PENETRATED SLIGHT ROTATION TO RIGHTTRACHEA SLIGHTLY DEVIATED TO THE RIGHTCARDIOPHRENIC AND COSTOPHRENIC ANGLES ARE FREERIGHT LUNG FIELDS ARE CLEAR.LEFT LUNG FIELD SHOWS A HOMOGENOUS OPACITY WITH SPICULATED MARGINS IN THE UPPER ZONE CARDIAC SHADOW APPEARS NORMALNO BONY ABNORMALITIES DETECTEDBORDER 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 MALIGNANCYDIAMETER >6 CMSPICULTAED MARGININVASION OF MEDIASTINUM

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

10. Symptoms in central growthCoughBreathlessnessHemoptysisWheeze

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

12. Thank you