Study Syllabus for Classification of Radiographs of Pneumoconioses
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Section 2: Parenchymal Abnormalities (Continued)
Radiograph #11 through Radiograph #14 demonstrate large pneumoconiotic opacities. Radiograph #11 is quality 2 due to mottle, and shows an A 12-mm opacity underlying the right third anterior rib. There is coalescence of small opacities ax in the right upper lobe. There are coexistent background small pneumoconiotic round opacities r/q involving all lung fields, profusion 2/2. Other abnormalities include ax, and hi.
Radiograph #12 demonstrates large opacities that when summed would be categorized as B since the sum of their longest dimensions exceeds 50 mm but the sum of their dimensions does not exceed the area of the right upper zone. For illustration purposes, if only one of these two were present, the individual classifications would be as follows: the large opacity underlying the right second anterior rib would be A and the opacity underlying the left first and second anterior ribs is about 50 mm in size or A. A poorly defined nodule seen through the heart in the left lower zone could be an additional large opacity. (For further review of this image, see Radiograph #24.)
Radiograph #13 presents several large opacities whose dimensions when summed, exceed the area of the right upper zone and are therefore collectively classified C. The large opacities involve the middle and upper lung zones on the left and right. There are coexistent background small pneumoconiotic opacities q/q involving all lung zones, profusion 3/3. Other abnormalities include bu, di, em, id, and ih.
Radiograph #14 demonstrates a B size opacity in the left upper lobe. Two additional opacities are seen in the RUZ between the second and third anterior ribs and the right infra hilar area overlying the distal end of the anterior right 4th rib. Since together they do not exceed the area of the right upper zone, they should be collectively reported as large opacities, size B.The symbol ax refers to an area of coalescence of small pneumoconiotic opacities (rounded or irregular) within which the margins of the individual opacities are still identifiable. A true large opacity such as the opacity seen in the left apex has a more homogeneous appearance.
The distinction between a large opacity and ax coalescent opacities will be further illustrated in Subset 4.
If no large opacities are present, check O in Section 2C, large opacities. If one or more large opacities are present, check the letter A, B or C that best represents the area they would collectively occupy if they were contiguous.