FINAL REPORT
 CHEST RADIOGRAPHS
 
 HISTORY: Dry cough and malaise.
 
 COMPARISONS: None.
 
 TECHNIQUE: Chest, AP and lateral.
 
 FINDINGS: Fissures are thickened and the interstitium is moderately prominent. The bones are probably demineralized. Projecting over the medial left upper lobe is a focal opacity which has vague borders and measures about 3 cm. The heart is mild-to-moderately enlarged. There is mild unfolding and calcification along the thoracic aorta. The chest is hyperinflated. There is no definite pleural effusion or pneumothorax. This is compatible but not diagnostic of a focal consolidation. A pulmonary mass with associated atelectasis would be an additional consideration.
 
 IMPRESSION:
 
 1. Cardiomegaly.
 
 2. Focal opacity in the left upper lobe, which could be seen with consolidative pneumonia, but a mass is not excluded.
 
 3. Findings consistent with mild-to-moderate interstitial pulmonary edema. Atypical infection or severe airway inflammation are other possibilities, but probably less likely.
 
 4. If clinical circumstances suggest pneumonia, then short-term followup radiographs could be considered within four weeks for close surveillance. Otherwise, chest CT could be considered, although the latter cannot always distinguish malignancy from infection.
