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