A 64 yo female presents with worsening breathlessness and cough over 2 weeks
Both lungs are crowded with 'cotton ball' infiltration with areas of coalasence and masking of domes and cardiac borders. Likely Malignant, Lymphangitis Carcinomatosis / Multiple Mets. DD: Fungal Infection / OLD due to Sclerogenic dust / Tuberculosis/ SARCOIDOSIS.
Diffuse fluffy opacities Likely diagnosis is Milliary TB with lung involvement, Aspergillosis. Other DDs are Metastasis, Sarcoidosis. Take history of haemoptysis, night sweat, weight loss, fever, appetite, other systemic sign symptoms etc. Advice Sputum for AFB +/- CBNAAT, CECT thorax, CBC with peripheral smear.
Bilateral extensive fibro cavitary lesions, also there is cannonball appearance. PTB / Metastatic lesions in lungs. CT scan chest and CT guided biopsy. Sputum for AFB, if negative then do CBNAAT, CBC, RBS LFT, RFT, Urine for RE and ME etc
Lymphangitis carcinomatosis Extensive fungal infilteation Multiple mets Tropical eosinophilia Macro milliary ptb Extendive bronchopneimonia( scan wise) Extensive alveolar pul odema as seen in ards
Symptoms insufficient. Any fever, decrease in appetite,and or any cough with sputum? D/D 1.Fungal infection(aspergillosis) 2.PTB 3.ILD 4.Bronchoalveolar carcinoma 5.Secondaries Do HRCT FOB AND SPUTUM FOR AFB AND HEMOGRAM Fungal staining of sputum should also be done
DD-- 1.Metastasis from breast cA/Choriocarcinoma 2.PTB. 3.Aspergilosis.
Lung Metastasis(Canon ball appearance) /Milliary Tuberculosis /Asbestosis
Ards ....rule out retroviral disease and fungal PNEUMONIA..
Metastasis but rule out tuberculosis
Cotton wool opacities, ild byssinosis Or fungal or mets
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