? Reverse cerscent sign

This CT image belongs to 40 year old male who had pulmonary tuberculosis in the past 4 years ago.His present symptoms are rt upper chest pain, occasional fever, recurrent hemoptysis,
What is your diagnosis ? How will you treat this person ?

First non radiology intrigue

This is a middle aged lady who had bilateral hilar adenopathy .What is the skin lesion?

Answer-Erythema nodosum

What is your diagnosis ? Why?

Fibrotic band in right upper lobe, caseating mediasinal nodes, left pleural effusion - Diagnosis is tuberculosis

62 year old male , non smoker, oral tobacco user , reported with intermittent chest pain and sweating since 1 month, large intermittent bouts of hemoptysis for 1 week, Normal gastroscopy and inconclusive bronchoscopy .
Based on this image what is the diagnosis ?

50 year old female with chronic cough , off and on hemoptysis , off and on dyspnoea and wheeze.
Pt is a diabetic and has had koch's 5 years ago.
What is the clinicoradiological diagnosis.?

Why no shift?

This is obviously a large pleural collection .
Question - Why there is no mediastinal shift to opposite side ?
What are likely diagnosis ?

Answer - Most likely cause is an endobronchial obstruction ( mass lesion)causing the lung to collapse and compensate .

In this case there was none . This was a slowly evolving , loculating tubercular empyema which developed over 6 months.

This is a patient with cough, copious sputum , frequent LRTI
What is your diagnosis ? What are two classical radiological signs on this image ?

Bronchiectasis . 1) Signet Ring sign 2) Tram tracks sign

Honeycombing seen from a different viewpoint

77 year old male , progressive exertional dyspnoea over 3 years, extensive leathery rales

What is the likely diagnosis ? How will you confirm ?

IPF -UIP , Thoracoscopic lung biopsy if relevant ,

Tap ? Drain ? Surgery?

60 year old man presented with fever ,dyspnoea , chest pain for 2 months.
Question - What is the diagnosis ? How will you treat this condition.?

Loculated Empyema . Thoracoscopic drainage and biopsies.

Bronchopulmonary Segment

Can you identify the segment of maximal involvement ?
Answer - RUL anterior and posterior segments

This is a CT image of a man presenting with severe dyspnoea, hypoxemia and chest discomfort.

What is the imaging called as ? What is the diagnosis?

Answer -CT pulmonary angiogram . This is pulmonary thromboembolism

This is a 30 odd year old man who had a small amount of hemoptysis . Presently he has right lower chest pain.
What is the diagnosis ? How will you confirm it ?

Answer - Pulmonary AV malformation , CT pulmonary angiogram

25 year old male with 1 month history of high grade fever, 2 kg weight loss, loss of appetite.
What is your diagnosis ? How will you confirm it ?
Answer - Tuberculosis , Bronchoscopy

CT thorax of a patient with dyspnoea

This is 52 year old female patient who has exertional dyspnoea for last 20 years.
What is the special radiological finding in this image?What is the diagnosis ?

Answer - Left lung collapse with herniation of right lung onto left half.

This blog is meant for any student/ Specialist in pulmonary medicine.
I plan to put up an X ray/ CT scan on this blog everyday and will post the correct/final diagnosis the next day . you are free to write your answers over next 24 hours and do write your comments.