Can you tell whether this radiodensity is pleural or extrapleural ?

This is a loculated pleural collection.

What is a pregnant lady sign?

50 year old diabetic male, past h/o tuberculosis , presents with massive recurrent hemoptysis,fever and toxaemia.What is the CT scan thorax reflecting ? What is your diagnosis?

Necrotizing consolidation with large cavity with solid tissue within tha cavity and bits attched to wall. Clinical background makes it highly suggestive of invasive aspergillosis.

40 year old nonsmoker male presents with cough and  exertional dyspnoea . What is the radiological pattern ?What is the differential diagnosis?

Canon ball lung nodules, mostly metastatic disease.

In real life this was a tough conclusion to reach at, Bronchoscopy revealed endobrochial lesion LLL,Biopsy report adeno ca -first pathologist,second opinion no malignancy,CT guided FNA -no malignancy,tru cut biospy - no malignancy, Finally VATS biospy of a full nodule -adeno ca confirmed.

Another unusual feature of this disease - despite such widespread lung disease never had spread beyond lungs for nearly 5 years.He was one of our spectacular responders to Gefitinib.

Answer - Ill defined radiodensity on X ray chest PA view , can be consolidation /mass lesion.

CT thorax makes it more convincing for a mass lesion.Bronchoscopic biopsy -Histopath -AdenoCa

58 year old female with 10 kg weight loss over 6 months

Occasional hemoptysis and some cough.

What is Xray interpretation ? How will you investigate?

35 year old male ,with history of PTB 5 years ago , now presents with recurrent hemoptysis.

Read this Xray and give your final diagnosis.

Well defined rounded radiodensity with an air crescent on top.Diagnosis is aspergilloma

31 year old lady, fever, weight loss , loss of appetite , dry cough .

How will you confirm this diagnosis ?

Caseating paratracheal lymph node- Best way to get the diagnosis is to do a bronchoscopy and perform TBNA -Transbronchial needle aspiration from the node.Also collect corroborative data like ESR,TT,etc

Answer to yesterday's puzzle

35 year old, non smoker male , presents with exertional dyspnoea -for last 2 years, progressive.

Discuss the differential diagnosis?

?14 year old girl ,fever ,weight loss ,loss of appetite 2 months.

how will you proceed from here?

LUL fibrocavitary infiltrates. ESR,TT,Sputum AFB -3 days ,get the basics right.