December 2015 Imaging Case of the Month

Thursday, December 3, 2015 at 8:00AM
Rick Robbins, M.D. in CT scan, bronchoalveolar lavage, bronchoscopy, chest x-ray, diagnosis, differential, dyspnea, extramedullary hematopoiesis, ground glass opacity, polycythemia vera

Michael B. Gotway, MD 

Department of Radiology

Mayo Clinic Arizona

Scottsdale, AZ

 

Clinical History: An 80-year-old woman with a history of polycythemia vera (12 years), migraines, hypertension, and gastroesophageal reflux disease presented with complaints of declining functional status due to worsening shortness of breath over 3-4 weeks’ duration. She also complained of occasional palpitations. No history of fever, cough, chest pain, or hemoptysis was elicited. A frontal chest radiograph (Figure 1) was performed.

Figure 1.  Panel A: Frontal chest radiograph obtained at presentation, when the patient complained of worsening shortness of breath. Panel B: 3 years earlier.

Which of the following statements regarding the chest radiograph is most accurate? (Click on the correct answer to proceed to the second of five panels)

1. The frontal chest radiograph shows abnormal mediastinal contours
2. The frontal chest radiograph shows fairly diffuse, bilateral, increased opacity
3. The frontal chest radiograph shows layering pleural effusions bilaterally
4. The frontal chest radiograph shows multifocal consolidation
5. The frontal chest radiograph shows no abnormal findings

 

Cite as: Gotway MB. December 2015 imaging case of the month. Southwest J Pulm Crit Care. 2015;11(6):254-9. doi: http://dx.doi.org/10.13175/swjpcc150-15 PDF 

 

Article originally appeared on Southwest Journal of Pulmonary, Critical Care and Sleep (https://www.swjpcc.com/).