Sixty years old gentle man, no smoker, came to my clinic c/o fever,cough and dyspnoea of 5 days duration. Started on Amoxicillin + Clavulanic acid for 5 days and far better today. But his X-Ray chest taken today is like this. No past H/o PT. Known case of DM and HTn on regular treatment. Kindly comment


There are 6-7 well circumscribed round lesion. Few small and few very big lesion in both the lung chest.. It is highly suggestive of metastatic malignant lesions.. Other possibility is primary malignancy of the lung.. Fever was due to secondary infection. Which responded to Antibiotics.. Suggested CECT THORAX to delineate the exact nature and extent of the lesion.. ct guided fnac from one of those lesions will clinch the diagnosis... May need pet scan for further staging if needed....
Respected sir want to know that what would be a better choice in such kind of pt bronchoscopy first or direct ct guided biopsy

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There are multiple lung masses- one in right upper zone, right lower zone, one behind the heart on left side and a nodule close to left heart border. Also there is right pleural effusion. Please do a contrast-CT of chest to delineate the masses better followed by CT or USG- guided fnac or trucut biopsy of mass to know cell type. Bronchoscopy needs to be done to find out intrabronchial extension, if any and also to obtain biopsy and BAL. However, these could also be metastases from a distant site. USG of abdomen to know prostate status and serum PSA may be helpful.
Homogenous opacity in rt upper zone with rt pleural effusion with? rt basal consolidation with opacity in left lower zone adv.. cect thorax ? malignant ?? hydatid cyst if malignant.. ct guided fnac and biopsy of lung mass or bronchoscopy and biopsy other investigation.. sputum for cytology hydatid serology
to me it looks like mets lungs. search primary kidney or other organ like thyroid male breast etc. Pet ct will possibly clinch the diagnosis n would be cheaper too compare to ct chest n whole abdomen. If not available then good clinical exam followed by ct chest n whole abdomen.
Ruz rmz mass lesion with RT sided minimal effusion with probable rt lower lobe collapse there is another solitary coin shaped lesion in Lt lower lobe Cect chest should be done to confirm
Malignant lesion on right hilar region with upper lobe atelactesis, rt pleural effusion (small), rt lower lobe pneumonia. Left lower lobe coin lesion ( metastatic).
This does not look like TB but definitely malignancy -- needs CT chest / biopsy for further diagnosis staging treatment.
Malignant leison Rt. upper lobe with secondary left lower lobe. Minimal PLEF Rt. cp angle. Lung collapse Rt. upper lobe.
mass compressing upper lobe bronchus causing collapse with met in left lower lobe
metastatic malignant lesion with supperaddef infection c.t.guided biopsy
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