Bochdalek Hernia – On Chest Radiograph
History: 60 year old male with incidental finding on a chest radiograph. This is the typical appearance of a Bochdalek Hernia on a chest radiograph.
Unilateral Opaque or “White Out” Hemithorax – Differential Diagnosis
History: 60 year old male with shortness of breath. The differntial diagnosis for unilateral opaque hemithorax is broad, and includes large pleural effusion, empyema, hemothorax, complete lung collapse, pneumonectomy, community acquired pneumonia, bronchogenic carcinoma, pleural masses such as mesothelioma, and finally pulmonary agenesis. This patient had complete collapse of the left lung secondary to a […]
Aortic Nipple – The Left Superior Intercostal Vein
History: 50 year old male with cough. This is the typical appearance of the “aortic nipple” on a chest radiograph. This opacity is caused by the left superior intercostal vein, which lies immediately adjacent to the aortic arch in this region. It is a normal finding seen in less than 5% of patients.
Solitary Pulmonary Nodule
History: 70 year old male with cough. This is a solitary pulmonary nodule (SPN). An solitary pulmonary nodule is a single, focal, rounded opacity that measures less than 3 cm. If larger than 3 cm, it is termed a “mass.” Up to 90% of nodules less than 2 cm are benign. Stability over two years […]
The Portable Chest Radiograph
History: 25 year old asymptomatic male. There are many pitfalls to the portable chest radiograph. The difference is in where the x-ray beam is being shot from and where the film is placed. In a normal PA radiograph, the x-ray beam is coming from behind the patient and the heart is closest to the film. […]
Allergic Bronchopulmonary Aspergillosis
History: 50 year old male with productive cough. This is a case of allergic bronchopulmonary aspergillosis (ABPA). ABPA is a hypersensitivity reaction (Type 1, mediated by IgE and IgG) most commonly to aspergillus fumigatus. It commonly occurs in patients with cystic fibrosis. The round opacities in the CT image above represent dilated bronchi impacted with […]
Bochdalek Hernia
History: 50 year old male with incidental finding on chest CT. This is a diaphgragmatic hernia. There are multiple types of diaphragmatic hernias. Two of which have eponyms assigned to them are Bochdalek hernias and Morgagni hernias, of which can be either congenital or adult. A Bochdalek hernia occurs at the posterior pleuroperitoneal hiatus, or […]
Tree in Bud Pattern – Differential Diagnosis
History: 50 year old male with cough. This is the classic appearance of the “Tree in Bud” pattern seen on chest CT. The differential diagnosis for this pattern is broad, and includes infectious bronchiolitis (bacterial, viral, fungal), bronchiectasis, allergic bronchopulmonary aspergillosis, and aspiration pneumonia. Other more rare entities that can manifest in this pattern include […]
Fused Rib or Rib Synostosis
History: 50 year old man with chest pain and shortness of breath. This is the appearance of a fused rib, or rib synostosis. Typically fused ribs are either congenitally fused or can become fused as a result of remote traumatic injury to the region of the fused ribs. Rib synostoses are relatively common, present in […]
Tracheal Bronchus, Pig Bronchus or Bronchus Suis
History: 60 year old male undergoing chest CT for follow up of a lung mass. This anatomical variant is referred to as a tracheal bronchus. When the entire upper lobe is supplied by the accessory bronchus, it is called a pig bronchus. An excellent article summarizing these anatomical variants is present here. These variant bronchi […]