Retrocardiac mass: lung cancer
Smoker of 30 pack years. Weight loss and chronic cough.
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2 cm left retrocardiac nodule. The background lungs are hyperinflated in keeping with COPD. Small right sided pleural effusion.
A "must not miss film" whether in an exam or real life. This is lung cancer until proven otherwise. In the exam:
- Describe findings.
- State, "I am concerned this may represent a malignancy and warrants further investigation."
- State, "Necessity to refer urgently to a respiratory physcian with a view to CT and bronchoscopy."
This is the reason the retrocardiac space is one of the review areas for all chest x-ray interpretations.