Lung cancer

Case contributed by A.Prof Frank Gaillard

Patient Data

Age: 80 years
Gender: Male
X-ray

The PA radiograph shows a large left mid zone mass which can be localised to the posterior of the chest by using the silhouette sign. The left heart border remains visible indicating that the mass cannot be anterior. Some of the left hilar vessels remain visible (hilum overlay sign) indicating that the mass is not centered at the hilum. The mass therefore must be located posteriorly within the apical portion of the left lower lobe. This is confirmed on the lateral radiograph. 

CT

Large left lower lobe mass is present, with narrowing of the left lower lobe main bronchus and artery. 

Case Discussion

Large cancer with the apical portion of the left lower lobe.  Nice example of how the silhouette sign and hilum overlay sign can help localise a chest lesion on a frontal projection alone.

Cytology:

Bronchial washings left lower lobe - malignant cells originating from a non-small cell carcinoma, best seen in the bronchial  brushings from the left lower lobe, where the cytomorphology is suggestive of adenocarcinoma.

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Case information

rID: 38665
Case created: 28th Jul 2015
Last edited: 13th Nov 2015
System: Chest
Inclusion in quiz mode: Included

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