November 2014 Imaging Case of the Month

Michael B. Gotway, MD

Department of Radiology

Mayo Clinic Arizona

Scottsdale, AZ

Clinical History: A 38-year-old non-smoking woman presented with complaints of intermittent dry cough, occasional vomiting, and dyspnea, occasionally with fever and chills. She indicated that she has suffered recurrent bouts of bronchitis and pneumonia annually over the previous 10 years. The patient had a history of upper arm localized melanoma resection 10 years earlier. She had smoked for 10 years, but quit one year prior to presentation. Her past medical and surgical histories were otherwise unremarkable.

Frontal and lateral chest radiography (Figure 1) was performed.

Figure 1. Frontal (A) and lateral (B) chest radiography.

Which of the following statements regarding the chest radiograph is most accurate? (click on the correct answer to proceed to the next panel)

1. The chest radiograph shows asymmetric pulmonary vascularity
2. The chest radiograph shows bilateral linear and reticular opacities and diminished lung volumes suggesting fibrotic lung disease
3. The chest radiograph shows mild, bilateral, streaky central opacities, possibly reflecting airway thickening
4. The chest radiograph shows numerous small nodules
5. The chest radiograph shows volume loss involving the right thorax with a mass-like opacity projected over the right hilum

Reference as: Gotway MB. November 2014 imaging case of the month. Southwest J Pulm Crit Care. 2014;9(5):264-77. doi: http://dx.doi.org/10.13175/swjpcc147-14 PDF

October 2014 Imaging Case of the Month

Sameh Sakla, M.D.

Clinton Jokerst, M.D.

Department of Medical Imaging

University of Arizona Medical Center

Tucson, AZ

A 53-year-old man presents with fatigue and dyspnea on exertion. An admission chest radiograph (Figure 1) was obtained.

Figure 1. Admission chest radiograph.

What is the best term or phrase used to describe the salient radiographic abnormality?

1. Diffuse thick-walled cavitary lesions
2. Interstitial and alveolar pulmonary edema with effusions
3. Miliary nodules
4. Patchy consolidation
5. Tension pneumothorax

Reference as: Sakla S, Jokerst C. October 2014 imaging case of the month. Southwest J Pulm Crit Care. 2014;9(4):214-8. doi: http://dx.doi.org/10.13175/swjpcc126-14 PDF 

January 2014 Imaging Case of the Month

Michael B. Gotway, MD

Department of Radiology

Mayo Clinic Arizona

Scottsdale, AZ

Clinical History

A 77-year-old man presented for an executive health physical. His past medical history was significant for coronary artery disease, renal stones, gout, and a left nephrectomy for clear cell renal carcinoma 17 years earlier. Chest radiography (Figure 1) was performed. Prior chest radiographs from the previous year (Figure 2) and 7 years earlier (Figure 3) are shown for comparison.

 

Figure 1. Frontal (A) and lateral (B) chest radiography. 

 

 Figure 2. Frontal (A) and lateral (B) chest radiography performed one year prior to presentation. 

Figure 3. Frontal chest radiography performed 7 years prior to presentation.

Which of the following statements regarding the chest radiograph is most accurate? (Click on the correct answer to move to next panel)

1. The chest radiograph shows a mass
2. The chest radiograph shows an unusual cardiac configuration
3. The chest radiograph shows basal predominant linear opacities suggesting fibrosis
4. The chest radiograph shows multifocal ground-glass opacity and consolidation associated with linear and reticular abnormalities
5. The chest radiograph shows multiple nodules

Reference as: Gotway MB. January 2014 imaging case of the month. Southwest J Pulm Crit Care. 2014;8(1):27-40. doi: http://dx.doi.org/10.13175/swjpcc002-14 PDF