Chest Xray - Pathological findings

Pathological findings?

 

Diaphragmatic hernia

 

Raised lt. hemidiaphragn
possible causes
1) traumatic rupture
2) phrenic nerve paralysis
3) scar contracture pulling the diaphragm up ( post tubercular complication )

 

Left diaphragmatic rupture

 

Elevation of left hemidiaphragma is present.Gastric air bubble is not seen.Contour of hemidiaphragm is regular.

I think first diagnosis should be subdiaphragmatic mass such as colonic neoplasma,abscess formation or splenomegaly .
second diagnosis is phrenic nerve paralysis.

 

In differential hernia hiatus.

 

Had a re-look at the Xray....







so, i guess this may be an Xray chest of a old case of tb with possible reactivation esp. becos both upper zones, show some infiltrate and in the light of the suspected subpulmonic effusion. I can see some fine miliary scattering as well....in short the case needs to be thoroughly investigated and a "Quantiferon Gold Test" ( not mantoux), if available shud be sought 4 in addition to the other investigations.

Hope Johnald, throws further light on the Xray (-:

 

Thank you very much

 

U r welcome, but what is the answer ?

 

This was a case of an alcoholic and smoker 89 years old man with a laryngeal squamous cell carcinoma causing a left phrenic nerve paralysis

 

thanks 4 sharing the case and furthering the message - "Cigarette Smoking & Drinking is Injurious to Health".



P.S: He may have had TB as well in the past, considering his social habits.