#ItsTime #TB

A male aged 66 years p/w complaints of Fever (Low Grade), Cough and recurrent Hemoptysis since 2 months.....He has documented weight loss of around 8 kgs in two months...He underwent CT and PET CT also as advised by the treating physician as his initial investigations were s/o TB...comment on his CT and PET images and discuss the findings

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Physical picture of pt shows distension of abdomen with protrusion of umbilicus 2nd chest xray shows cavitory lesion rt coastal chest mid apical zone Fibrochachiatic lesions and infiltrates discreetly placed bilaterally Hrct supports thin walled cavity in rt mid zone Petscan shows big opaque lesson rt apex D/d malignancy lung with secondaries Sos tuberculosis
Thanx dr Pushkar ji Bhomia
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Multiple Cavitatory lesion in both lung. May suggest CA lungs BUT there is sign of metastasis to the liver in the CT. Colon cut off sign may signify Acute pancreatitis due to hypercalcemia secondary to Lung Carcinoma. (may be due to squamous cell carcinoma wich secrete parathyroid hormone like causing hypercalcemia) Or inframatory bowel disease. Carcinoma colon Carcinoma stomach.
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Abd distention seen. Changes of COPD emphysema with few emphysematus bullae seen. Tracheomalsia noted with rt sided deviation. CT thorax showing bil fibrobronchiectatic lesions with emphysematus bullae Fibrocalcified scattered lesions seen. Pleural fibrosis seen. Metastatic lesions seen in lungs and liver.
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Pulmonary koch's.. Malignancy..
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PTB Sequel D/D Malignancy
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bronchioge.nic ca
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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!
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Seems primary lung carcinoma wd ?Mets to liver
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Left upper lobe in lungs on PET
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Agreed with Dr.Shivraj A
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