(New case) PA x-ray: unclear (pleural) mass.

chron pleural empyema
What would we do to diagnose without CT?
(Click here for the answer)

See 62.

Little change in projection.

Bild 62

better proiection
How is the patient rotated? What do we clearly see in this projection?
(Click here for the answer)

We see rotation slightly in the direction of a LAO projection. It clearly demonstrates the calcified outer and inner wall of the mass:
classical persistent effusion with calcified inner and outer wall.

This new 43-year-old patient  suffered a Grenade splinter injury 36 years ago and had a persistent pleural empyema. The process remained clinically silent. - Repeatedly without knowing older radiographs a new pneumonia was diagnosed. History was not adequately examined.

Bild 63

pleural not parenchymal
Is it really a pneumonia?
(Click here for the answer)

Irregular shadowing but no aerobrochography. We want to see a different projection and/or CT.

This is a conventional tomography; the patient, lying on his back, lifts his right hemi thorax so he reaches a RAO-position.

Bild 64

tomography pleural
What do we see?
(Click here for the answer)

We see a mass enveloped by irregular calcifications;
we see the classical distancing from the chest wall. The neighbouring lung is free.

65.This patient’s CT with this small persistent
empyema (with a shrinking trend).

Bild 65

CT small pleural cavity