Pericardial Effusion – The Oreo Cookie Sign
History: 50 year old male with shortness of breath and chest pain. This is the classic “Oreo Cookie Sign” of pericardial effusion on the lateral chest radiograph. The most anterior radiolucent line (indicated by the red arrow) is the epicardial fat, the radiopaque line is the pericardial effusion, and the posterior radiolucent line (indicated by […]
Metastatic Extraskeletal Osteosarcoma
History: 55 year old male with left flank mass on physical exam. The diagnosis in this case was metastatic extraskeletal osteosarcoma, which is a malignant mesenchymal soft tissue tumor that contains components of cartilage, bone, and osteoid. Unfortunately, these tumors have a poor prognosis, with an approximately 25% 5 year survival rate. Notice the pleural […]
Sarcomatoid Mesothelioma
History: 55 year old male with a right lateral chest wall mass seen on a prior chest radiograph. The differential diagnosis for the right lateral chest wall mass visualized in the three MR images above includes mesothelioma, primary lung carcinoma, soft tissue sarcomas such as fibrosarcoma and malignant fibrohistiocytoma, fibromatoses such as desmoid tumors and […]
Accessory Azygous Fissure
History: 50 year old male with cough. This is the typical appearance of the accessory azygous fissure, which demarcates a portion of the right upper lobe of the right lung supplied by branches of the apical segment bronchus. It is a normal variant which is seen in about 0.4% of the population.
Coronary Artery Bypass Graft with Left Internal Mammary Artery
History: 67 year old male with cough. This is the typical location of vascular clips seen in a patient who has undergone coronary artery bypass graft surgery with the left internal mammary artery. A nice paper on this surgery from 1977 is located here.
The azygoesophageal stripe
History: 40 year old male with cough. Normal chest radiograph showing a nice example of the azygoesophageal stripe.
Bronchitis – The B6 Bronchus
History: 65 year old male with productive cough. This is a case of bronchitis. The bronchi seen on end near the hila are the B6 bronchi, which supply the superior segment of the lower lobes bilaterally. The B6 bronchi in the radiograph above are seen well because they are oriented perpindicular to the x-ray beam, […]
Metastatic Malignant Mesothelioma
History: 60 year old male with left sided chest pain. This is a case of pathology proven metastatic malignant mesothelioma. These are tumors of the pleura, and are most likely secondary to long-term asbestos exposure, in which there is a dose-response relationship and typically a latent period of 30-45 years. Asbestos plaques are not a […]
Calcified Splenic Cyst
History: 50 year old male with chest pain and shortness of breath has an incidental finding. The differential diagnosis for a calcified mass projecting over the left upper quadrant of the abdomen includes prior granulomatous disease such as histoplasmosis or tuberculosis, arterial calcifications such as a splenic artery aneurysm, splenic infarction, and splenic cyst. Less […]
Atelectasis
History: 60 year old male with fever, cough, and shortness of breath. This is complete collapse of the lateral basal segment of the left lower lobe, which can also be describe as partial atelectasis of the left lower lobe. Lobar collapse occurs when an entire lobe of the lung is not aerated. Obscuration of the […]