Bronchogenic carcinoma with metastatic lymphadenopathy

Case contributed by Dr Mohammad A. ElBeialy


Cough and chest pain.

Patient Data

Age: 85 years
Gender: Male

Frontal and lateral chest radiographs reveal right paratracheal lobulated mass lesion with a right infraclavicular spiculated mass lesion that extends superiorly associated with thickened right apical pleural cap as well as mild right pleural effusion. 

  • A large right middle mediastinal heterogenous and necrotic nodal mass lesion is seen at the right paratracheal / retrocaval region measuring about 9 X 8.5 cm in its maximal cross-sectional diameters. 
  • Enlarged tracheobronchial as well as pretracheal, prevascular and enlarged right hilar lymphadenopathy. 
  • A right lung upper lobe apical segment spiculated mass lesion about 5.5 X 2.5 cm is seen with possible invasion of the posterior superior pleura and associated pleural thickening.  The inferomedial aspect of the mass lesion is seen merging with the mediastinal lymphadenopathy. No bony rib destruction or CT evidence of bony deposits. 
  • mild right pleural effusion. 
  • clear left lung apart from a small left anterior basal atelectatic band. 
  • No left pleural or pericardial efffusion.
  • No gross cardiomegaly.
  • The scanned upper abdomen shows no evident abnormality. 

Case Discussion

Right lung upper lobe apical segment bronchogenic cancer with pleural invasion as well as malignant mediastinal and right hilar metastatic lymphadenopathy and right pleural effusion

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Case information

rID: 37671
Published: 18th Jun 2015
Last edited: 14th Aug 2019
System: Chest
Inclusion in quiz mode: Included

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