1. Describe two abnormalities on chest Xray
2. Give a likely diagnosis
Answer
1. a) Two opacities in the upper zones of the left lung
b) cavitations with thick walls in the left upper zone
2. malignant lesions with central cavitations
Discusion
Lung opacities with irregular margins are features of either primary or secondary malignancy. Cavitations within the lesion also favor this. Cavitations with thick irregular walls are more in favor of a malignant lesions. Always look for erosion of ribs, hilar lymph node enlargement, calcifications and plural effusion(which are not present in this case) when there is suspicious malignant lesions in the lung.
Squamous cell carcinoma commonly present as a large peripheral mass with central cavitation.
primary sites of pulmonary metastasis
female- breast, tthyroid
male- testis, colon
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