Right upper lobe opacity

Case contributed by RMH Core Conditions

Presentation

Hypertension, light headedness, diaphoresis - cardiomegaly? aortic pathology?

Patient Data

Age: 73
Gender: Male

Chest

Modality: X-ray

Right upper lobe opacity. Normal cardiac size. Lungs and pleural spaces are clear. 

Chest

Modality: CT

There are minor centrilobular emphysematous changes in the upper lobes of the lungs. There is a 5mm pulmonary nodules in the LUL anterior segment. No other pulmonary nodules demonstrated. No pleural or pericardial effusion. No thoracic lymphadenopathy. The right subclavian artery has a tortuous course. A 10 x 15mm ovoid soft tissue density most likely to represent a lymph node is noted at the bifurcation of the right brachiocephalic vein. 5.5cm simple cyst in the left kidney upper pole. No suspicious bone lesions.

Conclusion

1. Right superior mediastinal opacity seen on chest x-ray is secondary to a tortuous right subclavian artery.

2. Incidental 5mm (24mm3 by Lungcare) pulmonary nodule within the LUL. Given the smoking history, 6 month follow up with a low dose CT is suggested.

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Case Information

rID: 27938
Case created: 27th Feb 2014
Last edited: 13th Mar 2016
System: Chest
Inclusion in quiz mode: Included

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