Wednesday, February 22, 2006

COPD and CxR below


The CxR did not project the RUL lucency as well as I hoped... Jennings pointed out some of the density increase in the left: he does have some scarring throughout but the left side looks denser because of the right lucency. Check out his CT scan.
What would you recommend.

Answer below in the discussion.

4 comments - CLICK HERE to read & add your own!:

Arenberg said...

I'd stick a big needle in that black thing in the right lung to biopsy it (OK just kiddng, but you have to admit you want ot see what would happen if you just popped that balloon, don't you?).

I was looking on the CT for evidence of compressed (ie salvageable) normal lung next to the ginormous (if its not a word it should be) bulla. I did not see it, but if it is there, then bullectomy is reasonable. If not, then I wouldn't do anything surgical.

Jennings said...

I think maybe the haziness I saw on CXR in the right mid lung zone represents compression from the big bulla. Thus, bullectomy would certainly be a reasonable option here...

Mike L said...

The "ginormous" bullae are noted in the upper lobes.

What do the lower lung fields show? I.e. are there bullae in those as well?

Baleeiro said...

I wanted to do the same as Arenberg: pop the balloon and see what happens. Alas, rathe we discussed him in our LVRS clinic and he underwent VATS bullectomy. So the surgeon got to pop the balloon. His pre-op spiro was: FVC 72% and FEV1 33%. Post-op he is now 89% and 53% respectivelly and feels better.