Question

A 74-year-old gentleman presents to the OPD with a history of significant unintentional weight loss, loss of appetite, and iron deficiency anemia. A chest x-ray was done and is given below. What is the diagnosis?

• A. Bronchogenic carcinoma
• B. Mesothelioma
• C. Metastasis
• D. Pneumoconiosis

Hint:

Metastatic lung lesions typically present with multiple nodules throughout both lungs. A biopsy or further imaging (CT scan) is often required for confirmation.

Answer 1

The Correct Option is C

Bronchogenic carcinoma: Bronchogenic carcinoma, particularly non-small cell lung cancer (NSCLC), can present with a mass lesion in the lung. However, it typically presents with a central mass or hilar enlargement rather than multiple lesions as shown in the x-ray.
Mesothelioma: This condition is typically associated with exposure to asbestos and usually presents with pleural plaques or pleural effusions, not multiple lung lesions as seen in this case.
Metastasis: The chest x-ray shows multiple nodular opacities, which is highly suggestive of metastatic disease. Common sites for metastasis to the lungs include breast cancer, colorectal cancer, and renal cell carcinoma. The patient's history of unintentional weight loss, loss of appetite, and iron deficiency anemia are also concerning for metastatic disease, as these are systemic symptoms often seen with malignancy.
Pneumoconiosis: Pneumoconiosis is caused by inhalation of dust particles (such as coal dust or silica). It leads to fibrotic changes and can show nodular opacities in the lungs, but the pattern here is more likely to be metastatic in nature, given the clinical presentation. Thus, the correct answer is Metastasis (3), as the x-ray findings and the patient's clinical history strongly suggest metastatic lung lesions.