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What is the abnormality shown on the following chest X-ray and CT?

Penny’s Points Case # 5 PA & Lateral chest X-ray Steve Reeves M-4 Radiology Clerkship Block 3, 2009. This patient presents to the ED with symptoms of chest pain, shortness of breath and a cough. Fever has not been associated with this illness.

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What is the abnormality shown on the following chest X-ray and CT?

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  1. Penny’s Points Case # 5PA & Lateral chest X-raySteve Reeves M-4 Radiology ClerkshipBlock 3, 2009 This patient presents to the ED with symptoms of chest pain, shortness of breath and a cough. Fever has not been associated with this illness. • What is the abnormality shown on the following chest X-ray and CT?

  2. PA upright chest x-ray

  3. CT Angiogram

  4. A malignant cancer arising from the alveolar walls. Alveolar Cell Carcinoma Although the radiographic appearance may be suggestive of pneumonia, in this case, the absence of fever, the normal white cell count and further work-up is conclusive of alveolar cell carcinoma.

  5. Film Review Consolidation Two substances of the same density, cannot be differentiated from each other on X-ray. This phenomenon, the loss of the normal radiographic silhouette (contour),is called the Silhouette sign. Silhouette sign-

  6. Film Review The “CT Angiogram” sign is seen in areas of consolidation in this CT of a patient with alveolar cell carcinoma CT Angiogram sign- The ability to see normal pulmonary vasculature within parenchymal consolidations.

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