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Esam Alhamad, MD,FCCP, FACP Division of Pulmonary Medicine College of Medicine. Chest X-ray. Is this film centered?. Why do you have to know whether it is PA or AP film. ?. Is this a PA or AP film?. Is the exposure appropriate?. Mediastinal Masses. Anterior mediastinal masses (4Ts) - PowerPoint PPT Presentation
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Esam Alhamad, MD,FCCP, FACPDivision of Pulmonary MedicineCollege of Medicine
Is this film centered?
Why do you have to know whether it is PA or AP film
?
Is this a PA or AP film?
Is the exposure appropriate?
Mediastinal Masses
Anterior mediastinal masses (4Ts)
ThymomaTeratomaThyroidTerrible lymphoma
Middle Mediastinal Masses
3 As
AdenopathyAneurysm/vascularAbnormalities of development
Bronchogenic cyst Pericardial cyst Esophageal cyst
Posterior Mediastinal MassesNeural tumorNeurobalstoma, ganglioneuroma ,
Ganglineuroblastoma
Nerve root tumorsSchwannoma, neurofibroma
Airbronchogram
Indicates that the opacity is parenchymal not mediastinal or pleural
DDx:Consolidation ,Hemorrhage, Edema, Bronchoalveolar Cell Carcinoma, Lymphoma, Sarcoidosis, Alveolar Proteinosis
Pulmonary Hemorrhage
Pulmonary-renal syndrome
Wegener’s granulomatosisSLEGoodpasture’s syndromPolyarteritis nodosaHenoch Shonlein purpura
Pulmonary Hemorrhage
Without renal diseaseAnticoagulationPulmonary infectionPulmonary embolismTraumaBone marrow transplantation
Pleural effusion
InfectionNeoplasmCHFCirrhosisPancreatitisUremiaSubdiaphragmatic abscessCTD ( SLE, RA)HypothyrodismPulmonary embolism
Pleural effusion
“ITCH” Large unilateral pleural effusion
InfectionTumorChylous ( ruptured thoracic duct lymphoma)Hemorrhage
Pneumothorax
SpontaneousPrimaryCOPDAsthmaCystic fibrosisCavitary pneumoniaSarcoidosisPleural metastases
Pericardial effusion
SerousCHF, Hypoalbuminemia, CTD, Hypothyroidism
BloodyAcute MI, Trauma, Neoplasm, CRF
PurulentBacterial, Viral ,Tuberculosis, Fungal