An irregularly shaped somewhat spiculated mass measuring 2.4 x 2.8cm is identified in the lingular segment of the left upper lobe. There is a linear tail which appears to be a atelectasis extending to the pleural surface. There is no associated pleural thickening. Centrally within the mass are multiple focal radiolucencies suggesting this may represent an adenocarcinoma.
There is a 1cm subtle rounded area of groundglass opacity in a subpleural position postero-laterally in the left lower lobe. If the larger lesion proves to be an adenocarcinoma, this could represent either in situ disease at all well differentiated adenocarcinoma.
A minor region of atelectasis in the apical segment of the right lower lobe is unchanged. A non-specific opacity inferiorly and anteriorly in the right upper lobe may represent scarring.
In extensive changes of emphysema are seen.
There no enlarged hilar or mediastinal lymph nodes.
No suspicious bone lesions are seen.
- at the lingular segment left upper lobe mass has the appearance of a carcinoma, probably adenocarcinoma
- small groundglass focus in the right lower lobe could also represent adenocarcinoma either in situ or low grade
- there our bronchi passing into the lingular segment mass. It would be amenable to bronchoscopic biopsy