Imaging

Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary, Critical Care & Sleep publishes case-based articles with characteristic chest imaging and related pathology.

The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend. Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary, Critical Care & Sleep publishes case-based articles with characteristic chest imaging and related pathology. The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend.

Rick Robbins, M.D. Rick Robbins, M.D.

Medical Image of the Week: Extensive Small Cell Lung Cancer with Cardiac Invasion

A 73 year old woman was seen with a lung mass and acute onset of ataxia. MRI of the brain was notable for multifocal infarcts (Figure 1). Echocardiography (ECHO) was obtained to identify cardiac source of emboli and was notable for freely mobile mass tethered to the lateral left atrial wall, crossing the mitral valve into the left atrium (Figure 2). A contrast enhanced CT scan of the chest was obtained which confirmed the presence of a large right upper lobe mass with extension to the right pulmonary vein, left atrium and into the left ventricle (Figures 3 and 4). The biopsy confirmed small cell lung cancer.

Figure 1. Axial MRI brain showing multifocal embolic infarcts.

 

Figure 2. Transthoracic ECHO 4-chamber view showing a mobile mass originating within the left atrium, across the mitral valve, and into the left ventricle.

 

Figure 3. Axial CT of the chest showing tumor extension into the right pulmonary vein (arrow).

 

Figure 4. Coronal CT of the chest showing large right apical mass extending into the left atrium and across the mitral valve into the left ventricle (arrow).

 

Ryan Nahapetian MD, MPH.

Internal Medicine Residency.

University of Arizona at South Campus.

 

Carmen Luraschi-Monjagatta MD.

Division of Pulmonary, Allergy, Critical Care and Sleep Medicine.

Arizona Respiratory Center

University of Arizona

Tucson, Arizona.

 

Reference as: Nahapetian R, Luraschi-Monjagatta C. Medical image of the week: extensive small cell lung cancer with cardiac invasion. Southwest J Pulm Crit Care. 2013;6(3):143-4. PDF

 

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