| Try to
read the simple x-ray (a) that appears in this
month. Once interpreted then open the attached
x-ray (b) and then verify if your analysis agrees
with which we do.
1. Almost all left hemothorax presents/displays
as like dense "water", is to say is
opaque. Left pulmonary parenchyma has been replaced
by a fibrous weave that has produced fibro-thorax.
2. In the vertex of this side cleared images of
density are appraised "air" that resembles
clustered bubbles. They constitute a pulmonary
destructive pattern. In fact they are cystic,
secondary cavities to the retraction produced
by the adjacent fibrosis that excludes the hematosis.
3. The right lung has undergone a process of compensating
growth that has given rise to emphysema which
occupies all hemothorax and even exceeds the median
line by the mediastínal spaces and interfere
in left hemothorax (arrows) moving the mediastínal
lines.
4. The fibrous process, very plastic and retractable,
has inflicted an intense casualty of volume in
the left side. This is shown by the homo lateral
mediastínal retraction and it reveals the
displacement of the trachea.
5. The right vertex tampon is healthy. There is
a fibrotic apical cap, perhaps contemporary of
the injury that caused the destruction of the
left lung.
6. The pulmonary loss of parenchyma is accompanied
by a reduction of the pulmonary vascular bed.
This causes a difficulty in the hematosis, which
induces hypoxia, which produces pulmonary hypertension
and the circle is closed. Number 6 shows a superior
traction of the right pulmonary artery, but mainly
a remarkable prominent, with increase in the arterial
caliber.
The most probable cause, old pulmonary tuberculosis
with affects the pulmonary parenchyma and the
pleural cavity.
More images of cuts of TC of this process are
in the data base of images.
Author:
Juan I. Pérez Calvo
Servicio de Medicina Interna
Hospital Clínico Universitario “Lozano
Blesa”
Zaragoza
Translation: Lalit
Kumar |
