Darkening in the upper lobe of the right lung. Darkening in the lungs on fluorography what is it

It happens that an x-ray shows a darkening of the lungs in the picture. There can be both a darkening of the upper part of the lung on the x-ray, and the lower part, both on the right lung and on the left lung.
Any person, having discovered such an x-ray, will ask himself the question “What does this mean?”.

It is important to understand that this fact can be an alarming bell and warn of a pathological process or a painful physical condition. Darkening in the lungs on an X-ray in a child can occur for the same reasons as in an adult. The difficulty lies in the initial detection of pathology, since X-rays are rarely prescribed for children. This is due to the destructive properties of radiation, which adversely affect the human body, especially the child's body.
Any darkening of the lung on x-ray looks like a white spot in the picture. It can occur for various reasons and be of different sizes.

To begin with, it is important to know that the presence of a spot does not at all mean an unambiguous sign of a disease, sometimes the formation of spots can be an error of the X-ray machine (erroneous development technology, poor film quality, etc.).

Diseases that cause blackouts:

Within the framework of radiology, there are many different classifications of blackouts, which can indicate different causes of appearance in both an adult and a child. An experienced radiologist is able to isolate a certain type of spot and determine the cause, which was the decisive factor in its appearance in the picture.

Lobar and focal shading

Blackouts on an x-ray in an adult and a child are usually divided into lobar and focal. When the shading is lobar, the outlines of the spot can be clearly seen. As a rule, such a spot is a sign of a chronic pathology. It can be located both on the left and on the right lung.
In the second type of blackout, the spots are quite large (up to 1 cm in diameter) and indicate the presence of an inflammatory process. Sometimes this kind of darkening is a sign of vascular pathology or cancer. The causes can also be a heart attack of the left or right lung, tuberculosis and other diseases. If there is a headache and cough, this may indicate bronchopneumonia. A sign of bronchopneumonia is also pain in the upper part of the lung.
If there is thrombophlebitis and coughing up blood, then this indicates the likelihood of a heart attack of the left or right lung (depending on the location of the spot).

Classification of blackouts by shape and causes of appearance

There are blackouts of the following forms:

Indefinite form (lack of clearly defined outlines). To establish an accurate diagnosis, the radiologist, as a rule, prescribes additional clinical studies (CT, urine, blood, etc.). Possible diseases can be: pneumonia, infarction of the left or right lung, hemorrhage, the presence of any tumor or pleurisy.
Blackout liquid (tissue edema). This happens due to an increase in pressure in the vessels and the fluid from them enters the alveolar apparatus of the organ, as a result of which the proper functioning of the organ is disrupted. The cause may be a violation of the cardiovascular system.
Segmental shading. The triangular shape of the spot most likely indicates a tumor (cancerous or benign), fluid in the pleural cavity, pneumonia or tuberculosis. To obtain a complete and plausible picture of the disease, the doctor gives a referral for tests and prescribes additional examinations.
Focus dimming. For example, a round spot with a diameter of up to 1 centimeter can indicate pneumonia, tuberculosis or an abscess.
Encapsulated caseous focus. Sometimes it indicates an oncological disease, the presence of a lipoma or adenoma. However, for an accurate diagnosis, the patient also needs to undergo other examinations prescribed by the doctor and pass additional tests.

What to do if spots are found on an x-ray?

If you find any blackouts in the picture, do not immediately start to panic. Just listen to the doctor and take all the additional tests necessary to establish an accurate diagnosis and understand what it is.

Remember that x-rays are just an auxiliary diagnostic method that only supplements information about the patient's health status. Even the radiograph says "Conclusion", not "Diagnosis". In this regard, do not invent illnesses for yourself, but simply follow medical instructions.

The pathology of the lungs is detected during an x-ray examination in direct and lateral projections. The results may reveal various blackouts. These include extensive species, limited, rounded shadows. Various lung diseases give different forms of altered areas. The picture allows you to assess the condition of the respiratory system, make a diagnosis, a professional doctor will determine what this or that deviation means, and prescribe the appropriate treatment.

Main reasons

Darkening in the lungs on an x-ray - this can be inflammatory changes, neoplasms, infectious diseases. A similar picture is given by pathologies from the cardiovascular system, mediastinal organs, metastases from other departments. Consider the main reasons that can cause spots on the lungs on x-rays.

Pneumonia

It is the most common pathology of the respiratory system. For this reason, when characteristic symptoms appear, the doctor sends the patient for examination. The main and main manifestation of inflammation in the lungs is blackout. They differ in the type of infiltration, activity of the process, prevalence and localization. Pneumonia can occur for the following reasons:

bacteria;
viruses;
fungal flora;
protozoa;
mycoplasmas.

This is not a complete list of possible causes of the development of this pathology. Darkening in the picture depends on the stage of development of the disease:

High tide stage: a decrease in transparency of an uneven nature, without clear boundaries.
Hepatization stage: distinct darkening with pronounced borders.
Resolution stage: reduction in the severity of infiltration in the image.

The outcome of such a disease is the complete normalization of the x-ray picture. But usually there are some changes in the pattern, deformation of the roots of the lungs, etc.

The X-ray picture in pneumonia does not have a pronounced specific character. Therefore, the diagnosis is based on general complaints, anamnesis and the effectiveness of the treatment.

lung abscess

It is a formation that is filled with pus. More often it is the outcome of inflammatory lung disease. Also, the infection can enter the bloodstream, lymph. Dark spots in the picture depend on the stage.

At the beginning:

intense uniform shadow;
fuzzy contours.

As the abscess develops:

the formation of a cavity with smooth edges;
slight enlightenment in the middle;
area of inflammation around.

Often, a horizontal liquid level is considered in the cavity. Focal shadows in the lungs due to an abscess can become chronic. In this case, the image will reveal an irregularly shaped cavity with a zone of inflammation (sclerosis) around.

COPD

This group includes lung diseases, which are accompanied by diffuse changes. Frequent pathology - chronic obstructive bronchitis - in smokers (black lungs), workers in hazardous enterprises. Identification of darkening is possible against the background of a noticeable thickening of the walls of the bronchi. In this case, the pattern will be enhanced and its mesh deformation will be formed in the image.

Often, bronchiectasis develops with bronchitis. The main signs on the x-ray:

strengthening of the lung pattern;
cellular or looped seals with a zone of inflammation.

Symptoms that indicate the development of COPD are a persistent cough, sputum, chest pain, and difficulty breathing.

Emphysema

Accompanied by increased airiness of the lungs. Is the outcome of COPD, a pathology of the cardiovascular system. In the picture with emphysema, increased pneumatization, depletion of the pulmonary pattern or its complete disappearance along the periphery are noted.

Bronchial asthma

This disease also gives some changes during x-rays. The characteristic features include:

swelling of the lung tissue;
low standing diaphragm dome;
lengthening of the respiratory organs.

Also, X-rays can reveal complications of asthma in the form of atelectasis. They are areas where the tissue collapses.

If emphysema, asthma, or COPD is suspected, CT is preferable. This method gives more informative in relation to these pathologies.

Lung cancer

When conducting an x-ray, it is not possible to establish the histology (that is, the cellular composition) of the neoplasm. A dark spot on the lung due to cancer can be central, peripheral and bronchoalveolar.

Signs that there may be cancer of central origin:

the presence of a tumor originating from large bronchi;
characterized by expansion and deformation of the root;
violation of the patency of the bronchial tree.

With this form, growth can be observed in the lumen of the bronchus, beyond it, or have a mixed type.

Peripheral type of cancer:

more often in the form of a single formation;
the contours are bumpy, irregular in shape;
the presence of a "path" to the root of the lung.

Pancoast's tumor may occur in the upper lobes of the lungs. It is a type of peripheral species. It spreads quickly enough to the pleura, collarbone, shoulder plexus, which leads to severe pain.

Cancer symptoms may not appear for a long time. Often they are preceded by exposure to adverse environmental factors (ecology), prolonged smoking, the presence of a genetic predisposition. Also, a suspicion of a tumor may appear with poor fluorography.

Metastases

Most tumors metastasize to the lungs. It is not difficult to identify them with x-rays. They can appear in different lobes, in the lower right lung or left. In this case, the foci usually have a rounded shape. Spread from the primary tumor occurs through the blood or lymph. Therefore, a neoplasm of the brain, liver, and mammary gland often metastasizes to the respiratory organs.

Diffuse diseases

This group includes diseases that are accompanied by fibrosis and sclerosis. Under these concepts, the replacement of healthy lung tissue with connective tissue or its decrease in size is hidden. They are the outcome of other pathologies. The signs include:

reinforcement and mesh deformation of the pattern;
high diaphragm.

The phenomenon of the honeycomb lung is also revealed. With the help of x-rays, already late stages of the disease are detected.

Pneumoconiosis

Includes a group of occupational pathologies. These include asbestosis, silicosis, talcosis. Occurs when exposed to dust of various origins. Fibrosis gradually develops in the lungs. Signs:

small outlined nodes;
thickening of the pleura.

There is also an increase in peripheral nodes with the deposition of calcium salts.

Tuberculosis

Darkening on the lungs on fluorography is a suspicion of the presence of tuberculosis. This type of study is carried out to screen the population. Each species has its own characteristics in the x-ray. In clinical medicine there is a classification. Tuberculous intoxication is accompanied by a change in the general functions of the body, a sharp increase in the size of the papule, and is practically not reflected in the picture.

Primary has its own characteristics:

swollen lymph nodes;
an increase in the organs of the mediastinum;
lung tissue remains unchanged.

Tuberculosis of the intrathoracic lymph nodes is also distinguished. According to its classification, it belongs to the primary. Accompanied by compaction and foci of calcifications. Additionally, a complex is isolated, which includes all the above signs, plus the appearance of an inflammatory reaction track.

Disseminated tuberculosis:

multiple foci in the lungs;
round shape;
size 1-2 mm;
chain arrangement.

Such foci can merge with a long course. The classification distinguishes focal tuberculosis, which is characterized by:

single or multiple foci;
size up to 1 cm;
fuzzy contours.

Then there is a form of infiltrative tuberculosis. It is characterized by the presence of shadows larger than 1 cm. When merging, such foci can occupy several lobes of the lung at once. For caseous pneumonia, many confluent foci are characteristic.

Tuberculoma is distinguished separately in the classification. Signs:

a focus larger than 1 cm;
clear contours;
pronounced capsule.

The worst variant of tuberculosis is cavernous and fibrous. They are characterized by darkening in the form of a cavity with dense walls, without areas / with areas of fibrosis around.

Symptoms: fever, prolonged cough, positive sputum test, unsatisfactory result of flura.

Pleurisy

Effusion in the pleural cavity occurs in the presence of various kinds of respiratory diseases. Normally, this area contains a small amount of fluid, which allows the pleura to move freely. An x-ray can detect such a disease. The picture shows the liquid level in the form of a concave shape. As a rule, it is bilateral.

Changes on the X-ray can have a different shape and character, but in any case, this display is a reason to contact a specialist for the correct interpretation of the image. The identified pathology in this case will undergo immediate treatment.

X-ray of the lungs is a very informative method for diagnosing organic pathology, and, despite the emergence of more modern methods for its detection, it is still widely used in medical institutions. Detection on the radiograph of blackout in the lungs is the reason for the diagnostic search. In some cases, it is not difficult, but sometimes it can be quite difficult to find the true cause of the appearance of a pathological shadow in the lung. Therefore, for the purpose of treatment, additional examinations are required.

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What is a shadow on a radiograph, probable causes

The shadow on the x-ray of the lungs occurs most often due to the accumulation of fluid in the lumen of the pulmonary alveoli: transudate (edematous fluid) or exudate (inflammatory). In addition, the detection of pathological shadows is possible with obstruction of the bronchus and the development of atelectasis, with compression of the lung, with the replacement of the lung parenchyma with other tissues (for example, connective).

Sometimes shading in the projection indicates changes in the surrounding tissues: in the chest, diaphragm, mediastinum, pleura and pleural cavities.

When shadows are found in the picture, it is necessary to treat organic pathologies, and not about functional ones (asthma, etc.).

X-ray syndromes

X-ray manifestations of diseases of the lung tissue:

1. Extensive shading of the lung field.
2. Limited shading.
3. Round shadow.
4. Foci.
5. Extensive focal dissemination.
6. Extensive enlightenment.
7. Limited enlightenment.
8. Change in lung pattern.
9. Change in the roots of the lungs.

In the group of pathological shadows, syndromes are distinguished:

extensive shading of the lung field;
limited shading;
round shadow;
foci and limited focal dissemination;
syndrome of extensive focal dissemination.

Extensive shading in the projection of the image

The syndrome of extensive shading is characterized by the formation of a shadow in the projection of the entire or almost the entire lung. This phenomenon is based on compaction and airlessness of the lung tissue. Differential diagnosis of extensive shadows is based on identifying features of the nature of shading, the position of the mediastinum (displaced or not).

The mediastinum is an anatomical space bounded by the sternum (in front), the spine (back) and the lungs (side). The mediastinal organs (heart, blood vessels, nerves, thymus gland, esophagus) are surrounded by fatty tissue.

Features of a possible pathology in the syndrome of extensive shading:

limited shading

Limited shading may indicate both lung pathology and extrapulmonary localization of the pathological process. To finally determine the cause, it is necessary to perform x-rays in several projections. With intrapulmonary localization, the pathological shadow is located in the lung field on all projections and shifts along with the elements of the lung tissue during breathing. Formations emanating from the mediastinum during breathing do not move, compress the surrounding structures. The formations of the chest wall are displaced during breathing along with the ribs and are usually clearly visible on one of the projections.

The presence of limited shading, determined by X-ray or fluorography, may indicate inflammation such as:

1. pneumonia (infectious, paracancer, infarction-pneumonia with pulmonary embolism);
2. infiltrative pulmonary tuberculosis;
3. atelectasis;
4. hydrothorax (pleurisy, edematous fluid, pleural mesatelioma, etc.);
5. neoplasms of the chest wall, diaphragm and mediastinum.

Round shadow in the picture

A round shadow is a limited shading, but in all projections it retains the shape of a circle with a diameter of 12 mm or more. The syndrome of such a shadow requires differentiation of the localization of the process (intra- or extrapulmonary).

Among intrapulmonary pathological processes, tuberculosis (tuberculoma, spherical infiltrate, cysts, tumors, etc.) can give a round shadow on the radiograph. It is sometimes difficult to distinguish them from each other, but sometimes it is still possible to establish the reason for their appearance by the number and nature of the shadows. A single shadow with an increase in lymph nodes at the root of the lung indicates a high probability of primary lung cancer, multiple round shadows indicate the metastatic nature of the lesion, etc.

Often, an x-ray is prescribed for an informative examination of the condition of the lungs. Its implementation can be indicated to clarify the data of fluorography or the clinical picture of the patient's illness. Since, with lung diseases, the tissue density in the affected areas is usually increased, the x-ray will show a spot at this point in the image. When a patient, looking at the resulting x-ray, sees spots on it, the first thought that comes to mind is “cancer”. What does the darkening in the lungs on the x-ray mean, what can it be? And why do they arise?

Diffuse clouding - pneumonia of the entire left lung

Why do white spots appear on an x-ray?

The causes of white spots in the image can be various factors:

Bilateral inferior lung opacity (more on the left than on the right) and slight opacity on the left

For a more complete picture of the pathological process, in addition to the direct one, additional pictures are taken in the lateral and oblique projections. Each spot localized on an x-ray is evaluated by a doctor according to a number of parameters:

Location of darkness. It can be located in the upper region of the lung tissue, middle, and also in the lower. In addition, conditionally the lungs are divided into the inner zone, middle and outer. This makes it possible in the future to more clearly present the picture of the pathology.
The size. Refinement of this parameter allows you to set the area of the pathological process in the lungs.
The degree of expression. On this basis, the density of the lesion is determined. The spot in the picture can have a strongly pronounced intensity, weak or medium.
Blackout outlines. According to what contours the spot has, even or uneven, clearly expressed or not, it is determined, for example, the nature of the tumor or neoplasm.

There is another classification of spots on an x-ray, according to which the following different types of blackouts are distinguished.

Lobar dimming

With this type of spot, its outline is clearly visible on the x-ray. Moreover, it can be convex, have a concave or rectilinear shape. Such darkening in the lung may occur in the case of any chronic process. It can be a purulent process, cirrhosis or a destructive process of the bronchi.

As a rule, cancer and benign formations lead to the appearance of spots in the lower and middle zone of the organ.

Focal blackout

Such spots on the lungs are not too large, up to about 1 cm. They may indicate an inflammatory or other process that has just begun. In addition, the appearance of such blackouts in the picture may indicate vascular pathology. Due to the ambiguity of the cause, the doctor usually refers the patient for additional examinations (for example, CT, testing, x-rays).

Focal blackouts in the lungs may indicate the presence of peripheral cancer, pulmonary infarction, focal tuberculosis and other diseases. High fever, headache, cough and chest pain, combined with a similar x-ray picture, raise the suspicion of bronchopneumonia. A lung infarction is accompanied by symptoms of heart disease, blood spitting, manifestations of thrombophlebitis.

Focal pneumonia

Dimming indefinitely

Such spots are characterized by the absence of any specific shape and severity of outlines. An accurate diagnosis requires additional blood and urine tests, as well as the use of other diagnostic methods (for example, CT). Possible diseases in which vague white spots appear on an x-ray:

pneumonia;
lung infarction;
pleurisy;
hemorrhage;
tumor and others.

When making a diagnosis, laboratory data and the clinical picture of the disease are of great importance.

liquid blackout

Sometimes swelling of the tissues can occur in the lungs. If the pressure in the vessels rises, then it is possible for fluid to escape from them into the alveolar apparatus of the organ. In addition, a number of toxic substances can disrupt the permeability of the alveolar wall. In this case, the fluid also enters the lung tissue. The liquid in the lungs disrupts the functional activity of the organ.

Such pathologies, which occur most often in violation of the activity of the cardiovascular system, appear in the picture as a blackout.

Segmental dimming

Segmental pneumonia

If it has the shape of a triangle, then this indicates diseases such as:

cancer tumor;
good quality education;
pneumonia;
the presence of metastases from other organs;
tuberculosis;
the presence of fluid in the pleural cavity and so on.

An additional comprehensive examination is mandatory to make the correct diagnosis. Of great importance in this case are the experience and literacy of the doctor.

Focus Dimming

They are represented by round single spots about 1 cm. They can be with diseases such as:

pneumonia;
increased fluid content;
tuberculosis (tuberculoma);
cysts;
abscesses.

Tuberculoma of the lungs

Sometimes they are evidence of the presence of cancer or a benign tumor (lipoma, adenoma). In any case, an additional examination is necessary.

What to do if spots are found on an x-ray?

If your image shows dark or light shadows, don't panic. The best way out in such a situation is not to draw pictures of a terrible future, but to strictly follow the doctor's instructions.

Basically, when blackouts are detected on an x-ray, a thorough additional examination is required. Find out from your doctor what other diagnostic methods can provide the information you need to clarify the diagnosis, and go through them. Also ask what diseases or disorders can give the same picture. Maybe the reason is hidden in a completely different place.

If, after fluorography, you have found signs of the disease, you should not be completely upset. Life doesn't end there, even if you have dark spots on your lungs. Learn how to treat tuberculosis in this article.

Can tuberculosis be treated?

Tuberculosis, which causes dark spots on the lungs, is the most common disease today. The disease does not spare people of any age. But with proper treatment and timely detection, tuberculosis is completely curable. Only earlier it was believed that only people from the lower social classes can get sick with such a disease, but this is not so, this disease can overtake everyone, the main thing is to detect it in time.

How to diagnose tuberculosis?

The most accessible and common way to diagnose tuberculosis today is, of course, fluorography. The bigger the stain. The greater the likelihood of contracting this terrible disease. Dark spots on the lungs found during fluorography will tell a lot more than just listening or tapping the lung area by a doctor.

In addition to fluorography, the following symptoms will help to think about the fact that the lungs are not all right:

dry, prolonged cough lasting more than three weeks, cough with hemoptysis;

fatigue even after slight physical exertion - this can be not only a sign of spots on the lungs and tuberculosis as a result, but a sign of other diseases, so you need to urgently seek medical help;

the presence of dark spots in the lungs may be indicated by subfebrile temperature - 37 - 37.3.

The biggest danger of this disease is that it can not let you know about itself for a long time. A patient can get into the hands of doctors already in a neglected state and have either one dark spot on the lungs - an infiltrate, or a lot of dark spots - disseminated tuberculosis.

Progressive factors of tuberculosis

The following factors help to progress dark spots on the lungs:

frequent stress;

harmful working conditions;

chronic diseases of other organs (ulcer, diabetes mellitus)

pregnancy.

After infection of the body, a person may not know for a long time that bacteria are multiplying in his lungs and dark spots are expanding. The truth is revealed after developing a picture from a fluorograph. The doctor sees dark and light spots in the picture and deciphers them. In the picture, dark spots on the lungs, on the contrary, appear light, and light spots appear dark, so there is no need to be afraid if the doctor says that the picture shows dark spots.

How to treat tuberculosis?

Tuberculosis is a rather serious disease, which is simply impossible to ignore, since if left untreated, it can usually lead to death.

It is impossible to treat tuberculosis on your own, since uncontrolled medication allows Koch's wand to develop immunity and resistance to the drugs taken, in which case the treatment becomes at least ineffective.

As a rule, the treatment of the usual form of tuberculosis (the form that is sensitive to drugs) lasts at least 6 months and can even take up to two years.

To destroy dark spots on the lungs and infection, treatment is carried out systematically, pauses should not be allowed, in this case, tuberculosis will not progress.

After identifying the disease, a person infected with tuberculosis is placed in a hospital, where he must stay for about two months, during this period the bacteria of the disease cease to be actively excreted. And, when the doctor considers that the patient no longer poses a threat of infection to the people around him, he prescribes outpatient treatment.

Treatment regimen for dark spots on the lungs

The following drugs are included in the treatment regimen for the usual form of tuberculosis:

rifampicin,

isoniazid,

streptomycin,

ethambutol,

pyrazinamide.

How to treat tuberculosis - the main principles

The doctor selects an individual combination of drugs that will be taken for two or three months while the patient is in the hospital. If the treatment has little effect or no effect at all, this may mean that the infection has developed immunity to certain drugs, then the doctor makes adjustments to the chemotherapy process and prescribes other combinations of drugs, or the method of administering drugs to the patient changes (inhalation, intravenous) . If after two or three months a positive effect of treatment is detected, then the doctor prescribes the use of only rifampicin and isoniazid for the next four months.

After completing the course of taking medications, the patient must again be tested, if Koch's bacillus is again detected, it is determined that tuberculosis has acquired a drug-resistant form. Treatment of this form of the disease can last for years, second-line drugs are added to the main drugs: ethionamide, cycloserine, ofloxacin, pasque.

The most important thing in the treatment of dark spots on the lungs is never to lose heart and always follow the doctor's insistence, do not allow self-treatment.