24 year old lady with progressive exertional dyspnoea, Describe the radiological findings ?

Cardiomegaly with RV hypertrophy and prominent pulmonary conus.

67 year old male , non smoker , no DM, no HT , presented with progressive exertional dyspnoea , moderate restriction and hypoxia at rest, needed steroids to stabilize , stabilized steroids tapered and lung biopsy done

( He had similar episode about 18 months ago ).Looking at radiological pattern what can be predicted as histopath type.?

Dominent pattern is ground glass opacification and there is not much honeycombing. This is likely to be a non UIP disease.

35 year old female patient presents with history of cough, occasioanl hemoptysis, no weight loss, or loss of appetite, no fever,

ESR is raised, 3 sputum samples are negative for AFB , Sputum koh prep - no fungi seen

Describe the radiological findings .How will you investigate?

35 year old lady ,presented with fever off and on , cough and chest pain .what is the radiological finding ? What is the most likely diagnosis?

Right hemidiaphragm appears elevated, likely rt subpulmonic effussion.

60 year old diabetic male , survives serious sepsis ( intraabdominal ,post op), Needs prolonged ICU care , multiple antibiotics and just after discahrge starts getting cough and exertional dyspnoea. He is on linezolid and Levofloxacin at discahrge.He has normal WBC counts and procalcitonin levels are low. Clinically no sepsis.Describe the radiodesnsities and possible diagnosis?

multiple patchy consolidations, some nodular densities and areas with lot of bronchial wall thickening, clinical set up indicates non infective etiology.This was bronchiolitis obliterans with organizing pneumonia.

The symptoms responded to steroids and within 2 weeks CT normalized.

55 year old male with cough and fever for about 3 weeks, lower image is the one on day 1 , upper image is after 2 weeks . Spot the change between the two images ?

There are tiny air fluid levels within the radiodensity in the second image.This was a lung abcess which was masquereding as possible mass lesion in the lower image.

Look at the follow up X ray( on top ).

50,non smoker, non diabetic , asthmatic male on inhaled steroids 3 months, cough expectoration

wheeze, obbstruction on spirometry , on inhaled budesonide 1000 mcg /day.

SputumAFB- 3 negative , Describe findings? write possible DD.

Bilateral discrete nodular densities with two tiny cavities, Likely to be infective ,DD- tubercular,fungal

(Incidentally the lavage in this case confirmed Nocardiosis)

Person with a malignant pleural effusion on the right, Can you notice some additional findings? Clue - patient is getting face and upper limb edema.

Some mediastinal widening noted , New face and upper limb edema indicates SVC obstruction.

Identify and describe the radiological pattern ?

Radiodensities along the bronchi ,extending into nodular branching pattern .Tree in bud appearence.

48 year old ,nondiabetic ,nonsmoker male, presented with 8 days history of fever and dyspnoea.

History of similar illness 10 years ago.What is your diagnosis ?

Massive cyst with air fluid level , thin walled , mostly a bronchogenic cyst.

Elderly male , non diabetic, recently treated for TB , Enumerate all findings

1) Kyphoscoliosis 2) distorted lung architecture 3) Pleural tag left base with blunted CP angle

4) crowded ribs, elevated left hemidiaphragm left side.

1

This is a middle aged person who has been on ATT for last 3 years including second line agent.Comment on the Xray 1) regarding activity 2) Left lung findings

RUL fibrotic healed ,RLZ- ? active process, left lung fibrotic collapse, mediastinum pulled to left,trachea pulled to left, left hemidiaphragm pulled up. Don't pass the final verdict on activity unless sputum/BAL is repeatedly ZN smear and culture negative.
The lower image is the CT scan of the same patient who had a large bulla.

52 year old nonsmoker, known severe COPD with increasing dyspnoea over last 2 years. Is their any radiological abnormality which can explain the relatively new dyspnea ?

Large emphysematous bulla in right lung. ( Needed surgical resection after 3 years of supportive therapy.)

Both are bronchiectasis,Can you see the differences?

The top one is much older patient , (78 yrs), has more one sided disease process, there is no secondary infection.Also notice very prominent pulmoary vasculature on right and volume loss on left( incidentally he has severe pulmonary hypertension)

The lower one is a younger patient, bilateral disease, some air fluid levels s/o secondary infection

48 year old ,non smoker male, was diagnosed PTB 3 years ago,On ATT with first line agents, presents with high grade fever,cough and dyspnoea, What does the X ray Chest PA view reveal.

Extensive calcified nodules suggest disease healed long ago. ? cavity left mid zone?

60 year old ,chronic smoker , What is the pattern of this man's emphysema ?

Pan acinar emphysema .Compare this to one of the older images of centrilobular emphysema.

50 year old female presents with chest pain .What is the differential diagnosis?