Читать книгу Respiratory Medicine - Stephen J. Bourke - Страница 110

Various descriptive terms such as ‘rounded opacity’, ‘nodule’ or ‘coin lesion’ are used to refer to pulmonary masses. Carcinoma of the lung is the most important cause of a mass on chest X‐ray but several other diseases may cause a similar appearance (Table 4.1, Fig. 4.7). Features such as cavitation, calcification, rate of growth, the presence of associated abnormalities (e.g. lymph node enlargement) and whether the lesion is solitary or whether multiple lesions are present may provide clues to diagnosis. However, these features are often not reliable indicators of aetiology, and the X‐ray appearances must be interpreted in the context of all the clinical information. Further investigations such as computed tomography (CT) and biopsy (bronchoscopic, percutaneous, surgical) are often necessary.

Figure 4.3 Radiographic patterns of lobar collapse. Collapsed lobes occupy a surprisingly small volume and are commonly overlooked on the chest X‐ray. Helpful information may be provided by the position of the trachea, the hilar vascular shadows and the horizontal fissure. LLL, left lower lobe; LUL, left upper lobe; RLL, right lower lobe; RML, right middle lobe; RUL, right upper lobe.