Fig. 4.5 Primary lung carcinoma, lateral view

Findings: A cavitated round opacity is present at the right lung base. It overlies the back of the heart shadow on the lateral view. The location is thus right lower lobe. There are nodular opacities inside the cavity and an air-fluid level is visible.

Pattern: This is a mass pattern.

Differential Diagnosis: Malignancy is favored over inflammation because of the irregularity of the inner wall of the cavity. The air-fluid level is not useful in differential diagnosis; it only indicates that the bronchus connected to the mass is either partially or intermittently obstructed.

Diagnosis: Bronchogenic carcinoma, adenomatous.

Metastatic

Characteristics like shape, distribution, and multiplicity support metastatic mass diagnosis. Normal pulmonary markings (vessels) can be followed from the hilum toward the lung periphery in all directions. They branch at acute angles, taper, and diverge toward the periphery.