Image Based Question-67282

A chronic smoker presented with chronic shortness of breath with recent worsening.Chest X ray showed the following features.What can be the most probable diagnosis?

A. Right sided Lung carcinoma.

B. Right sided Pleural Effusion.

C. Right sided Pneumothorax.

D. Right sided Pneumonia.

Correct Answer » A Explanation

Ans:A. Right sided Lung carcinoma.

Chest X ray in the image shows:

• The left costophrenic angle is sharply defined (normal)(marked by yellow arrow)

• The right costophrenic angle is blunt (abnormal)(marked by red arrow)

• There is volume loss in the right hemithorax with corresponding shift of the mediastinum and trachea to the right (marked by blue arrow)

• Note: Pleural effusions do not cause volume loss.

Probable diagnosis:

• Lung cancer occluding the central airways with collapse of the right middle and lower lobes – which can be confirmed by CT and bronchoscopy