CHEST RADIOLOGY
QUIZ FOR B.C.G.
VIVEK PATEL
Case 1
• A 23 y/ male presented with acute onset of left
sided chest pain and breathlessness.
• Went to a physician who got an X-ray chest PA
which showed gross left sided pleural effusion.
• The effusion was tapped approx. one and half
lit.
• Within 24 hrs. again fluid filled up and a repeat
X-ray chest follows.
A follow up X-ray after refilling of
pleural effusion.
A CT scan was advised
A CT guided Bx was carried out
• Diagnosis????
• A correct differential
diagnosis will also be
given points. Maximum
of three d/ds are
allowed.
Case 2
• A 36 yr. male patient presented with dry cough
and progressive exertional breathlessness.
• An HRCT was advised.
HRCT
CASE 2
• What is the DIAGNOSIS.
• No d/ds are allowed.
CASE 3
• A 70yr./ Female presented with left sided
haemorrhagic effusion.
• Pleural fluid cytology for malignant cells was
negative.
• Patient was operated for Carcinoma of soft
palate before 20 yrs.
• Was advised a CT scan.
X-ray Chest
CT scan
CT scan (contd.)
What is the diagnosis????
• Differentials are allowed (max. 3)
• If the first differential is correct, full marks will
be awarded.
• If second or third d/d is correct 50% marks will
be awarded.
• If more than 3 d/d are sent, will be disqualified.
CASE 4
• A 46 yr/male presented with right sided chronic
chest pain and effusion. Patient had
occupational history of working with false
ceilings in the gulf for almost 30 yrs. At present
he had retired.
• An ICD was placed.
• Pleural fluid was straw coloured and didn’t show
any malignant cells.
• Was advised a CT scan.
X-ray chest
CT scan
CT scan (contd.)
CASE 4
• DIAGNOSIS ????
• A complete diagnosis is required.
• d/d not allowed.
CASE 5
• A 57 yr./male had c/o dry cough and wt. loss.
• Was being treated for pulmonary koch’s for past
four months without significant response.
X-ray chest
H.R.C.T.
CT SCAN (contd.)
CASE 5
• DIAGNOSIS?????
• No d/d allowed
CASE 6
• A 44 Yyr./male patient was referred to a
neurologist for severe headache.
• CSF examination was abnormal but not fitting
into T.B. or pyogenic meningitis.
• Patient’s HIV was negative.
CHEST X-RAY
H.R.C.T.
CT scan (contd.)
CASE 6
• DIAGNOSIS ????
• Maximum 3 d/d are allowed.
• If the first of the three d/ds is correct, full
marks will be awarded. If second or the third
d/d is correct 50% marks will be awarded.
CASE 7
• A 39yr./male had c/o chronic cough with two
episodes of haemoptysis.
• He was detected to have a right hilar opacity on
X-ray chest for which he was being treated with
Anti-T.B. for four months without significant
response.
• Was referred for a CT scan.
H.R.C.T.
Contrast enhanced CT
Coronal Recon. HRCT
Virtual Bronchoscopy
CASE 7
• DIAGNOSIS ????
• No d/d allowed.
CASE 8
• A 56 yr./female had h/o chronic cough and
breathlessness for four months.
• She is in to making potato wafers commercially
at home involving boiling of large qty. of
potatoes in closed room.
X-ray chest
End insp. HRCT
End-exp. HRCT
Coronal insp and exp. hrct
Case 8
• DIAGNOSIS ????
CASE 9
• Incidental abnormality noted on a non-contrast
CT of chest
Non-contrast CT chest
CT scan (contd.)
CT scan (contd.)
Case 9
• DIAGNOSIS ????
CASE 10
• A 16 yr./female presented with inspiratory
stridor.
• Bronchoscopy revealed extrinsic impression on
posterior tracheal wall.
• CT advised to r/o posterior mediastinal nodes.
X-ray chest
CT scan with oral and I.V. contrast
Coronal Recons.
CASE 10
• DIAGNOSIS ????