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  #1  
Old 06-21-2011
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Question Lung question

A 50 year old man presents with worsening of dyspnea of 6 weeks duration but is otherwise asymptomatic; Lung auscultation is normal; His chest x ray is shown below .
Which of the following is the most likely diagnosis?

A. Pulmonary TB
B. Sarcoidosis
C. Silicosis
D. Lung metastasis
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  #2  
Old 06-21-2011
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i dont think that it could be tb or metastasis..silicossi or sarcoidosis? i go with silicosis ...although we dont know about his job

if he had tb metastasis or sarcoidosis i think he should have more symptoms or findings...in the x ray i see sth like egg shaped found in pneumonioconiasis
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Old 06-21-2011
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I am not sure metastasis cannon ball appearance
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Old 06-21-2011
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i think its silicosis...may i know the source of q plz
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Old 06-21-2011
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Answer D. Multiple bilateral pulmonary parenchymal nodules varying in size and shape most commonly associated with metastatic disease to the lungs
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Old 01-10-2013
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Correct answer: B (by elimination)

Pulmonary TB: ruled out (No hx of fever, night sweats, weight loss, cough)

Silicosis: ruled out (No hx that is suggestive of exposure)

Lung metastasis: ruled out (that much metastases will NEVER give you an otherwise asymptomatic pxt)

Sarcoidosis:
1. we know this is a multi-systemic granulomatous diseases with the lung as the primary target organ
2. in the lungs, the CXR usually shows granulomas in the interstitium as well as mediastinal and hilar lymph nodes.
3. the hx fits the diagnosis (worsening dyspnea with no other symptoms)
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Old 01-12-2013
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what is the right answer?
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Old 01-12-2013
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My answer is LUNG METS.......multiple cannon balls...

Its not sarcoid accdng to me
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Old 01-12-2013
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Quote:
Originally Posted by aksyonez View Post
A 50 year old man presents with worsening of dyspnea of 6 weeks duration but is otherwise asymptomatic; Lung auscultation is normal; His chest x ray is shown below .
Which of the following is the most likely diagnosis?

A. Pulmonary TB
B. Sarcoidosis
C. Silicosis
D. Lung metastasis
This is how I will approach this question:

This CxR finding is possible in all four conditions but the patient is asymptomatic except dyspnea for relatively short ( 6 weeks) duration--this rules out A (should have systemic symptoms) & C (longer duration of dyspnea).

Now the CxR picture is more typical of Mets than Sarcoidosis since both can cause dyspnea for relatively short ( 6 weeks) duration in an otherwise asymptomatic patient. e.g. mets from testicular tumor.
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  #10  
Old 01-12-2013
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Default D

D. Lung metastasis for Sure
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  #11  
Old 01-12-2013
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Quote:
Originally Posted by aksyonez View Post
A 50 year old man presents with worsening of dyspnea of 6 weeks duration but is otherwise asymptomatic; Lung auscultation is normal; His chest x ray is shown below .
Which of the following is the most likely diagnosis?

A. Pulmonary TB
B. Sarcoidosis
C. Silicosis
D. Lung metastasis


Stage II sarcoidosis.
Stage III is infiltrates alone. See the image below.
Stage III sarcoidosis.
Stage IV is fibrosis

-this 2 cxrs for sarcoidosis in advance stage.so sarcoidosis never give u pic like that. the possible D.D FOR this cxr may be disamenated plum TB.

ans=D.
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