Answer of September 2006

Clinical History:

A 62 years old lady with history of HT and DM, admitted for malaise, weight loss and cough. CXR and CT thorax was done.

Diagnosis:

Tuberculosis

Discussion:

Plain chest radiograph shows a cavitating lesion over the right upper zone, overlapping the posterior right 5th rib. There is also consolidation of the
right middle lobe, with blurring of the right heart border. Computed tomography (CT) scan confirms the presence of a cavitating lesion over the right upper lobe, with air-fluid level demonstrated. Centrilobular nodules are seen in the lung window. Features are suggestive of post-primary pulmonary tuberculosis.