Video instructions and help with filling out and completing Who Form 1094 B Doesnt

Instructions and Help about Who Form 1094 B Doesnt

You we have two chest x-rays in front of us on the right hand side our normal chest x-ray once again that we have seen several times normal lung volume bilaterally normal mediastinum with normal widening normal hilar regions a or DIC arch is nicely visible you can clearly see right and left pulmonary arteries a Ordo pulmonary window is clearly visible right and left heart borders are clearly visible normal lung parenchyma with the usual vascular pattern there is no pleural thickening on periphery right and left main bronchi seem to be tapering gradually as the enter into the lungs there is no pleural effusion on either side as costophrenic angles are clearly visible now chest x-ray on your left hand side which is a P of U as well you can immediately notice decreased lung volumes on both sides but it is more intense on the left side trachea is not only dilated but you can see it is also slightly shifted towards the left side as if something at pulling it toward the left both right and left main bronchi are also a bit dilated they are not only dilated but also irregular in shape if you look at the left main bronchus you would agree that there is no gradual tapering as would be the case with a normal bronchus the appearance is suggestive of traction bronchiectasis both right and left pulmonary arteries have lost their definition looking at the mediastinum you can see that it not only widened but there is an architectural distortion looking at the lung parenchyma you can confidently say that there are multiple cysts scattered throughout both lungs which is commonly known as honeycombing also notice what is known as reticular pattern on both sides you would also agree that the honeycombing is more profound in lung basis as compared to apices honeycombing which is usually more profound in lung bases traction bronchiectasis architectural distortion and reticular pattern or reticular nodular pattern all are classic signs of lung fibrosis differential diagnosis of architectural distortion with honeycombing and traction bronchiectasis are idiopathic pulmonary fibrosis collagen vascular disease especially scleroderma asbestosis drug or radiation related fibrosis sarcoidosis and chronic hypersensitivity pneumonitis been diagnosed with idiopathic pulmonary fibrosis both lungs as a result of fibrosis are shrinking in volume creating architectural distortion and traction bronchiectasis slight shift of trachea towards the left side and dilatation is a result of fibrosis honeycombing is also a result of scarred interstitial which shrinks in size and thus results in destruction of alveolar walls creating mutliple thin walled cysts you

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