Chest X-ray - Scenario 1
Answers to scenario questions

Answers to scenario questions

Question 1

Can you link the X-ray findings to the presenting signs and symptoms?

  • Shortness of breath - consolidation and loss of volume due to raised hemidiaphragm (see question 4)
  • Arm swelling - venous and/or lymphatic compression
  • Hand pain - brachial plexus invasion
  • Voice changes (see questions 2)
  • Eye abnormality(see questions 3)

Question 2

Can you explain the change in her voice?

  • Recurrent laryngeal nerve invasion

Question 3

What is the cause of the small pupil of the left eye?

  • Horner's syndrome - ptosis, miosis, enophthalmos, anhydrosis - due to interruption of the sympathetic supply to the eye

Question 4

Why is the left hemidiaphragm raised?

  • Phrenic nerve invasion/dysfunction

Page author: Salisbury NHS Foundation Trust UK (Read bio)

Last reviewed: February 2016