57 yr old male , farmer , chronic smoker, no h/o DM or CAD presented with complain of breathlessness and cough with expectoration from last 3 yrs but both the complain have increased from last 15 days along with fever . Pls comment on the xray

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The wide intercoastal spaces and barrel shape chest with history of smoking does suggest emphysema but ruling out diseases like tuberculosis and pneumonia should be of the utmost importance. Further investigations including sputum analysis, tuberculin test and CBC.

Copd, empyema rt side most probably secondary to Pulmonary TB
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Everything is possible ,from AECB /Koch's / ca lung / farmer's lung all need is sputum microscopy for afb if negative --cbnaat , bronchoscopy with bal test , ct chest ,routine hemogram, esr, sputum for gram bact,

COPD emphysema. Large area of Rt mid,upper zone and small area of Left lower zone bronchiectasis with parenchymal destruction. Possibly Koch's relapse/superadded infections.

Copd Reactivzted ptb superimposed on old healed bilateral ptb Rt more then left However side by side ma.ignant process takung birth shld also be born in mind

COPD on left are pleural calcifications and on right mid zonal soft tissue consolidation likely bronchogenic Ca and needs CECT followed by bronchoscopy

Possibility of Ca lungs but ruled out PT .Ask for CT Lungs CBNNAT PCR to ruled out TB

Possibility of malignancy vs ptb Consider contrast ct

Consolidation rt mid upper zone fibrotic lesions lt upper zone.patchy fibrotic nodular region in lt mid lower zones.rule out lung Cancer with surrounding area of consolidation@drpradeep Patro

Left midzone ? Crescent sign Right. Upper and Midzone acinar lesions Rule out TB Mucirmycosis and malignancy Tuberculin test might not of help since over 50 % Indians positive

Chr Tuberculosis. Get sputum for AFB. also Exclude Pulmonary Embolism GetPulmonary Angio Done

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