Correct!
4. The chest radiograph shows homogeneous right lung opacity suggesting a large right pleural effusion
The chest radiograph shows fairly homogeneous opacity involving the right thorax, largely devoid of air bronchograms, and without significant volume loss- note that the trachea is positioned equidistant from each clavicle, when accounting for mild left anterior oblique patient positioning of the chest radiograph. If anything, minimal mass effect on the heart is noted, suggesting that the right thoracic process is space-occupying. Most of the right thoracic opacity is homogeneous without air bronchograms, suggesting that the process is extraparenchymal in location. When a space-occupying extraparenchymal process is present on a chest radiograph, an abnormality related to the pleura is the most likely consideration. The only clearly visible lung on the right side is present in the superior-medial right thorax. Some consolidation is present in this location, and lucencies are seen, suggesting that air-space disease is present in this location. However, most of the right lung process homogeneous and bland, without any features that suggest a parenchymal location [in particular, air bronchograms], which indicates that the right thoracic process originates from an extraparenchymal location. No nodules are present. The right-sided process has extensive contact with the right chest wall- far more so than the right mediastinum- which argues against a primary mediastinal location.
Which of the following is the least appropriate consideration among the differential diagnostic possibilities for the appearance of the patient’s chest radiograph? (Click on the correct answer to move to the next panel)