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Reasonable Rascal
11-16-03, 16:02
eMedicine Radiograph Case 27

BACKGROUND

A 47-year-old man presents with a chronic cough and chest discomfort that have lasted a few months. He does not have a fever, change of voice, or sputum production. He has no history of asthma and does not smoke. The clinical examination revealed generalized bronchial breathing. The findings were otherwise essentially normal. The medical history includes carcinoma of maxilla, which was treated with surgery and radiation therapy a few years ago. A chest radiograph was obtained. What is the diagnosis?

Hint

The medical history of this patient is significant.
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What is your diagnosis based upon the chest film? Suggested treatment, alternative or conventional?

RR
AGreyMan
11-17-03, 21:51
OK, I'll take a stab at it:

My guess is metastatic lung CA, as evidenced by the multiple lesions in both lung fields, esp. the R.

I'd get a biopsy of one of the lesions to be sure it wasn't histoplasmosis or something.

Compare the CA cells with the previous biopsy sample of maxillary CA to see if that is the source, though givent he Hx of that CA, it's a pretty good guess it is.

Start chemo or a macrobiotic diet or pray or whatever you are convinced is the best course of action for Tx.

How'd I do?

Stay Safe,
AGreyMan
Reasonable Rascal
11-22-03, 00:19
Metastasis to the lungs (cannonball lesions): The chest radiograph depicts multiple opacities in both lung fields consistent with pulmonary metastases. These metastases are commonly known as cannonball lesions because of their appearance. Treatment includes referral to an oncologist and usually chemotherapy, depending on the primary malignancy.

I dare say you did rather well.

RR
AGreyMan
11-25-03, 22:57
I cheated and got a consult.
Reasonable Rascal
11-25-03, 23:09
*Gasp!* My faith is shattered. :p

RR
AGreyMan
11-26-03, 14:39
At least I 'fessed up!
Reasonable Rascal
11-26-03, 15:01
Okay, granted. Now, what did you do with Jimmy Hoffa? :D

RR
AGreyMan
11-26-03, 18:32
Well, to be honest, I only know what happened to PART of Jimmy. The rest wasn't my assignment.

:)