Wednesday, 6 May 2015

xrayoftheweek 18: back to basics

A favourite of medical students and junior doctors this week for #xrayoftheweek: what can you see on this chest x-ray and what is the cause?

There are multiple, bilateral, rounded soft tissue density masses on the chest x-ray. There are also moderate sized bilateral pleural effusions, but the mediastinum looks normal, and there are no obvious bony lesions.

The pulmonary lesions have the look of cannonball metastases - the main differential for the causes is metastatic renal cell carcinoma and choriocarcinoma - other causes are much less common.

This is a coronal CT image of the abdomen and pelvis:

This shows a large right sided renal mass, later confirmed to be a renal cell carcinoma.


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