Paper

CHEST X RAY IN VARIOUS DIAGNOSES

OF HAEMOPTYSIS

Presented by:
Winda Saraswati
Yusdita Oktavia
Isma Resti Pratiwi

SUPERVISOR:
Letkol (CKM) dr. I Wayan Agus P., Sp.P
Haemoptysis

Haemoptysisrefers to coughing out blood.

Generally it appears bright red in colour as opposed
to blood from gastrointestinal tract which appears
dark red. It is considered an alarming sign of a
serious underlying aetiology.
Affecting factors of emergency in haemoptysis

Asphyxia because of the blood clots inside the respiratory

tract
Amount of blood during the haemoptysis may cause
hypovolemic shock
Pneumonia aspiration few hours or days after the
bleeding
Epidemiology

1930-1960 frequently caused by bronchiectasis and

tuberculosis infection
1971-1972 frequently caused by chronic bronchitis and
lung cancer
In developing country frequently caused by infection
In Persahabatan Hospital: Tuberculosis (64,43%),
bronchiectasis (16,71%), lung cance (3,4%)
Etiology

Infection
Cardiovascular
Neoplasma
Systemic (Coagulopathy)
Foreign Body in Respiratory Tract
Extrahepatic factors and amoeba abcess
Others causes
Tuberculosis

CXR shows
opacity
bilateral of
upper lobe lung
Cavity
shownby arrow
Shows primary
tuberculosis

CXR in Post Primary Lung TB

Mycetoma

Rounded
shaped soft
tissue looks
like mass in
surrounding
cavity
Crescent of air
(Monad sign)
shape shown
by yellow arrow

CXR in Mycetoma
Neoplasm

Opacity
findings in CXR
(unspesific)

CXR in Bronchoalveolar carcinoma

Fibrotic Cyst

Central
Bronchiectasis
with secondary
infection

CXR in Fibrotic Cyst

Bronchitis

Increase in
bronchovascula
r pattern

CXR in Bronchitis
Bronchiectasis

Increase in
bronchovascula
r and terminal
bronchus
ring shadows
Bilateral
bronchiectasis

CXR in Bronchiectasis
Pulmonary Emboli

Clear lung and pleura

cavity
Moderate pulmonary
congestion
NO pneumothorax and
free air in sub diaphragm
Enlargement of right
inferior pulmonary artery
(Fishers sign) with caliber
change (Changs sign)
show the pulmonary
emboly
CXR in Lung Emboli
Pulmonary Contusio

Opacity in lower left

peripheral zone
left anterolateralT 7th rib
fracture,

CXR in Pulmonal Contusio

Eisenmenger Syndrome

Cardiomegaly
Shorten pulmonary
artery

CXR in Eisenmenger Syndrome

Mitral Stenosis

Red line atrial

enlargment
Yellow line cardiac
silhouette (right
atrium, right ventricle,
and left ventricle)
Cardiomegaly
Double countour
Slaying sub carinal
angle (>120 degree)

CXR in Mitral Stenosis

Foreign Bodies

Both lungs expanding

perfectly, no focal
collapes or
consolidation
Increase of denisty in
left hillus

Radioopaque foreign
bodies rarely shown
Emphysema unilateral
frequently found

CXR in Foreign Bodies

Foreign Bodies

Often develop
pulmonary
haemorragic
Opasification of
airspace in both lung
Air bronchogram

CXR in Foreign Bodies

Lung Abscess

Generally rounded
cavity with air fluid
level in both frontal
and lateral
projection
Clear outlines
(consolidation often
obscures the lin

CXR in Lung Abscess

Granulomatosis

Multiple nodules or mass

vary in sie
Cavity in ~50% cases
Airspace opacity may
shown if the is
pulmonary consolidation
or haemorragic

CXR in Wegeners Granulomatosis

thanks!

Any questions?