CXR: Multiple Cavities

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CXR: Multiple Cavities

  1. 1. CHEST SKIAGRAM FOR DISCUSSION DR AMUDHAN PROF Dr E. DHANDAPANI ‘S UNIT
  2. 3. <ul><li>X-ray chest PA View </li></ul><ul><li>Properly positioned,good penetration with full inspiration </li></ul><ul><li>Trachea slightly to left </li></ul><ul><li>Bony and Soft tissue shadow normal </li></ul><ul><li>Costophrenic angle free </li></ul><ul><li>Hyperinflation of lung </li></ul>
  3. 4. <ul><li>Large cavity with surrounding emphysematous changes – upper & middle zone with bronchiectatic changes –middle & lower zone of right hemithorax. </li></ul><ul><li>Multiple cavitatory lesions seen in upper &middle zones with nonhomogenous opacity & bronchiectatic changes in lower zone of left hemithorax. </li></ul><ul><li>Fibrosis of both upper lobes </li></ul>
  4. 5. <ul><li>Chest xray shows tracheal shift to left </li></ul><ul><li>Multiple cavitatory lesions bilaterally </li></ul><ul><li>left hilum pulled up </li></ul><ul><li>Areas of consolidation left mid and lowerzones </li></ul><ul><li>Areas of bronchiectasis </li></ul><ul><li>Fibrosis both upper lobes </li></ul>
  5. 8. <ul><li>CT THORAX </li></ul><ul><li>Fibrotic changes B/L upper lobe with bronchiectatic changes in left lower lobe </li></ul><ul><li>Multiple cavitary lesion in both lungs. 11x3x5.4 cm sized thin walled cavity in right lung </li></ul><ul><li>10 x 2 x4.2 cm cavity in left lung. </li></ul><ul><li>Patchy consolidation left lower lobe & B/L Fibrosis with traction bronchieactasis in left upper lobe. </li></ul>
  6. 9. <ul><li>A cavity is defined as an air containing space within the lung surrounded by a complete wall of 1mm or greater thickness </li></ul><ul><li>Thin walled cavity has a wall thickness of <1mm </li></ul><ul><li>Bulla is a type of thin walled cavity </li></ul>
  7. 10. FEATURES TO NOTED IN A CAVITY <ul><li>Location </li></ul><ul><li>Outline </li></ul><ul><li>Wall thickness </li></ul><ul><li>Air fluid level </li></ul><ul><li>Contents of cavity </li></ul><ul><li>Satellite lesions </li></ul><ul><li>Surrounding lung parenchyma </li></ul><ul><li>Intracavitary nodule </li></ul>
  8. 11. Location <ul><li>TB cavity usually upper zone </li></ul><ul><li>Posterior segment of upper lobe &apical segment of lower lobe </li></ul><ul><li>Site of lung abscesses following aspiration depends on patients position at time of aspiration usually lower zone and right sided </li></ul><ul><li>Pulmonary infarcts are usually lowerzone </li></ul><ul><li>Pulmonary sequestration usually left side lower zone </li></ul>
  9. 12. Thin walled cavity <ul><li>Bullae </li></ul><ul><li>Pneumatocele </li></ul><ul><li>Inactive TB cavities </li></ul><ul><li>Cystic bronchiectsis </li></ul><ul><li>Hydatid cysts </li></ul><ul><li>Traumatic lung cysts </li></ul>
  10. 13. Thickwalled cavity <ul><li>Acute abscesses </li></ul><ul><li>Squamous cell carcinoma </li></ul><ul><li>Lymphoma </li></ul><ul><li>Most secondaries </li></ul><ul><li>Wegener’s granulomatosis </li></ul><ul><li>Rheumatoid nodules </li></ul>
  11. 14. <ul><li>Satellite lesions are commonly seen in benign conditions like TB </li></ul><ul><li>Fluid levels are seen in lung abscess </li></ul><ul><li>Fluid levels are uncommon in cavitating metastases & TB cavities </li></ul>
  12. 15. Intracavitory nodules <ul><li>Aspergilloma </li></ul><ul><li>Inspissated pus </li></ul><ul><li>Blood clots </li></ul><ul><li>Necrotic tumour </li></ul><ul><li>Cavernoliths </li></ul><ul><li>Pulmonary gangrene </li></ul><ul><li>Ruptured hydatid cysts with daughter cysts floating within cavity </li></ul>
  13. 16. <ul><li>THANK YOU </li></ul>

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