cxr - cavity in lung

IMAGING OF THE WEEKIMAGING OF THE WEEK

DR. PRIYA KUBENDIRAN

M1 UNIT

PROF. DR. RAMASAMY

• CXR PA view

• Adequate exposure

• Soft tissue & bony shadow normal

• Trachea in midline

• Heart shadow normal

• Lung parenchyma - a wedge shaped opacity seen in superior part of Rt lower zone with a thick walled irregular cavity

• Lateral view – wedge shaped opacity corresponding to right middle lobe with a cavity with ectatic changes with associated collapse

• IMPRESSION

A thick walled cavity right middle lobe with ectatic changes with associated collapse

? PT sequelae

? malignancy

CAVITY A gas containing space within the lung surrounded by a

complete wall ≥ 1 mm in thickness Occurs when an area of necrosis communicates with a

patent airway Features : 1) location

2) wall thickness

3) outline

4) fluid level

5) contents

6)surrounding lung

7) multiplicity

ETIOLOGY Infectious : bacterial

fungal

parasites Immunologic : Wegener’s granulomatosis

sarcoidosis Neoplastic : primary neoplasms

haematogenous metastases Thromboembolic : septic thromboembolism Airways disease : bullae

cystic bronchiectasis Traumatic : traumatic lung cyst Developmental : sequestrated segment

bronchogenic cyst

• Acute abscesses• Neoplasms• Metastases• Wegener’s granulomatosis• Rheumatoid nodules

• Bullae• Pneumatocoeles• Cystic bronchiectasis• Chronic inactive TB• Hydatid cysts• Traumatic lung cysts

Acute lung abscessPrimary malignancyPost traumatic lung cyst

MetastasesWegener’s granulomatosisSeptic emboli

KlebsiellaS.pneumoniaeTBFungalCarcinomaBullaeSarcoidosis

Ps.aeruginosaTBHydatid cystSeptic thromboembolismBronchiectasis

Staph.aureusWegener’s Metastases

PSEUDOCAVITATION / BUBBLE LUCENCIES

• In HRCT, round/oval areas of low attenuation ≤ 5 mm in diameter are visible within lung nodules

• Seen in bronchoalveolar ca (60 %)

acinar cell carcinoma (30 %)• Represent 1) patent bronchi

2) air containing cystic spaces

• If ≥ 5 mm : 1) paracicatricial emphysema

2) localised bronchiectasis

3) tumor developing in an area of fibrosis &

honeycombing

Bubble lucency

Pseudocavity

Water lily signHydatid cyst

Fungal ball

Wegener’s granulomatosis

SCC