65 yr old female, an olf case of pulmonary tuberculosis. C/o productive cough n evening fever Plz comment on x-ray Also on cardiac shadow



Lung field showing fibrosis and calcification ( left>>>right) with few fluffy shadows( a prominant one in left upper zone which could be a mass lesion consistent with age of patient) Past H/O T.B... Present complain of productive cough and fever. Diagnosis- Pnuemonitis ...if not controlled with a short course of antibiotic then think of Old healed Tuberculosis with reactivation. But patient being in extreme of age do CECT thorax to rule out malignancy. Heart shadow not clear due to significant fibrosis and mediastinal shift ( trachea appear to shift left).

I agree with most what has been mentioned by Dr.Husain except that before final confirmation cect chest and sputum examinations are mandatory.

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Rotated film. Fibrotic left lung with calcifications left upper homogenous opacity With non homogenous opacities in right lung Probably reactivated TB Advised CT chest to rule out mass lesions and active TB focus along with sputum AFB and gene xpert

Improperly positioned.present fibrotic shadows cd be due to old healed Tb .go for sp AFB/abnaat.there is a mass in LT upper zone.compare with old x Ray .if new cect required.

Extensive fibrocavitory cochs... Mediastinal shift to right.. lung collapse... segmental consolidation on left lower mid zone.. may be pneuminitis too.. Chances of malignacy like apical pancoast tumor or mass in left apex... Must be ruled out By HRCT.. Do CBNAAT to rule out MDR kochs... Do CBC ESR URINE ROUTINE C REACTIVE PROTEIN.. PROGNOSIS LOOKS POOR...

Inhomogeneous opacities in right apical and middle lobe and destroyed left lung field with mediastinal shift to the right side.afb stain of sputum recommended with esr and xenexpert and treat accordingly

Old healed PulmTB. Where is the heart ?Do C T and find out.

Extensive fibrosis in a case of old PAN with probably fungal infection .sputum nd HRCT should be done.

Due to wrong position, one can't comment on mediastinal shift and position of heart. Old case of TB either with re activation or secondary infection. Advised sputum for AFB and CBC. Treat accordingly either with ATT or broad spectrum antibiotics.

Lt. Fibrosed lung... Rt.pneumothorex.. Rt.mild pleural effusion... Routine blood urine and sputum AFB...To ro recurrence of koch's..

Rule out immunosuppressant along wth above all consideration.

old pulmonary koch's with fibrosis of the left upper zone with tracheal deviation to rt with compensatory emphysema on right side; may be reactivation of koch's with new episode of fever

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