(New case) PA x-ray: unclear (pleural) mass.
- What would we do to diagnose without CT?
(Click here for the answer) See 62.
Little change in projection.
Bild 62
- 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
- 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
- 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
