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Chest Xray - Pathological findings

Discussion in 'Spot Diagnosis' started by Johnald, Apr 7, 2013.

  1. Johnald

    Johnald Active member

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    Pathological findings?

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  2. enrybony

    enrybony Well-Known Member

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    Diaphragmatic hernia
     

  3. neo_star

    neo_star Moderator

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

  4. White man

    White man Young Member

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    Left diaphragmatic rupture
     

  5. bb100

    bb100 Bronze Member

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    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.
     

  6. Emergency medicine Mike

    Emergency medicine Mike Bronze Member

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    In differential hernia hiatus.
     

  7. neo_star

    neo_star Moderator

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

    [​IMG]


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    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 (-:
     

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  8. Johnald

    Johnald Active member

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    Thank you very much
     

  9. neo_star

    neo_star Moderator

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    U r welcome, but what is the answer ?
     

  10. Johnald

    Johnald Active member

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    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
     

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  11. neo_star

    neo_star Moderator

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

    SMOKING & DRINKING DANGEROUS.jpg

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

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