Case 1
A 36-year-old male presents with fever, malaise and productive cough.
What is the main abnormality?
a) Mediastinal abnormality
b) Hilar abnormality
c) Bony abnormality
d) Lung parenchymal abnormality
e) Normal appearances
Case 2
A 48-year-old female presents with fatigue and generalised weakness. Haematological investigations revealed a pancytopenia.
What is the main abnormality?
a) Lung parenchymal and bony abnormality
b) Mediastinal and bony abnormality
c) Pleural and bony abnormality
d) Bony abnormality
e) Lung parenchymal and mediastinal abnormality
Answers
Case 1
d) Lung parenchymal abnormality. There is increased opacification at both apices (arrows) with probable cavitation at the right apex (blue arrow). This patient was subsequently diagnosed with tuberculosis (TB).
In primary TB, the initial focus of infection can be located anywhere within the lung and TB can present with a wide variety of different appearances. Cavitation is relatively uncommon in primary TB occurring in 10–30% of cases. There may also be evidence of mediastinal …