Darkening at the apex of the lung. What does darkening in the lungs mean on x-ray?

It happens that an x-ray shows darkening of the lungs in the image. There may be a darkening of the upper part of the lung on the X-ray, as well as the lower part, both on the right lung and on the left lung.
Anyone who discovers such an X-ray will ask the question, “What does this mean?”

It is important to understand that this fact can be an alarm bell and warn of a pathological process or 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 identification of the 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 an x-ray appears as a white spot on the image. 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 mean an unambiguous sign of a disease; sometimes the formation of spots can be an error of the X-ray machine (faulty development technology, poor film quality, etc.).

Diseases that cause darkening:

Within radiology, there are many different classifications of darkening, which may indicate different reasons for the appearance in both an adult and a child. An experienced radiologist can identify a specific type of spot and determine the cause that was the decisive factor in its appearance on the image.

Lobar and focal darkening

Darkening on an x-ray in an adult and a child is usually divided into lobar and focal. When the darkening is lobar, you can clearly see the outlines of the spot. As a rule, such a spot is a sign of chronic pathology. It can be located on both the left and right lung.
With the second type of darkening, the spots are quite large (up to 1 centimeter 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 thrombophlebitis and coughing up blood occurs, 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 reasons for their appearance

There are blackouts of the following forms:

Indefinite shape (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 may be: pneumonia, infarction of the left or right lung, hemorrhage, the presence of a tumor or pleurisy.
Liquid darkening (tissue edema). This happens due to an increase in pressure in the vessels and the fluid from them exits into the alveolar apparatus of the organ, as a result of which the proper functioning of the organ is disrupted. The cause may be a disruption of the cardiovascular system.
Segmental darkening. 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 may 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 undergo additional tests.

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

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

Remember that x-rays are simply 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 your doctor’s instructions.

Fluorography is a method of x-ray examination that involves photographing an image of an object from a screen. Darkening in the lungs on fluorography - what is it? This question is asked by many people whose fluorographic images are ambiguous.

An eclipse can simultaneously speak about a lot or nothing at all, so if the radiologist gives such a conclusion, you should not be nervous - because such patients are prescribed a pre-examination. Darkening on fluorography can be either a sign of pathology or a simple defect in the image.

Darkening in the lungs can be due to: pneumonia, bronchitis, tuberculosis, tumors, cancer, trauma, foreign objects, abscesses, fluid accumulation and prolonged smoking. In medicine, these are the most common causes of eclipses.

Digital codes used in fluorogram evaluation

Code	Decoding
1	Ring shadow
2	Darkening in the projection of the lungs
3	Focal shadows in the projection of the lungs
4	Widening of the mediastinal shadow
5	Pleural effusions
6	Fibrous changes in lung tissue (common)
7	Fibrous change in lung tissue (limited)
8	Increased transparency of lung tissue
9	Pleural change (common)
10	Pleural change (limited)
11	Petrifications in the lung tissue are large, numerous (more than five)
12	Petrifications in the roots of the lungs are large, numerous (more than five)
13	Petrifications in the lung tissue are small, numerous (more than five)
14	Petrifications in the roots of the lungs are small, numerous (more than five)
15	Large petrifications in lung tissue (single)
16	Petrifications in the roots of the lung are large (single)
17	Petrifications in lung tissue are small (single)
18	Petrifications in the roots of the lung are small (single)
19	Changes in the diaphragm not associated with pleural pathology
20	Condition after lung surgery
21	Changes in the chest skeleton
22	Foreign body
23	Cardiovascular disease
24	Other
25	Norm
26	Marriage

Darkening in the picture is not necessarily a pathology

Darkening in the picture does not necessarily mean oncology or tuberculosis, although this, of course, can also indicate a serious pathology. In addition, an eclipse may appear in the picture if you smoke cigarettes for a long time (see).

Hence, it is difficult to immediately determine what darkening in the right or left lung may mean on fluorography. Maybe a foreign object got there?

This often happens with curious children. Note that the types of eclipses are not directly related to pathologies, and the problem cannot be immediately determined by the shape of the spot.

A dark spot on the lung on fluorography is divided by number and size. Single spots indicate tumors; they can be malignant or benign.

If there is more than one darkening in the lungs on fluorography, then this indicates the presence of several pathologies. The location of the spots is also important.

So, if a darkening in the lungs on fluorography shows damage to the apex of the organ, then this may indicate tuberculosis, but the doctor must prescribe, in addition to tests, a repeat image.

Interpretation of a fluorography image

If there are shadows, the doctor writes out a presumptive diagnosis.

Strengthening the vascular pattern

Typically, the increased vascular pattern is caused by shadowing of the pulmonary arteries or veins. Its increased appearance is a sign of bronchitis, the early stages of cancer or pneumonia. Also, this may indicate shortcomings in the functioning of the cardiovascular system.

Compaction and expansion of roots

Compaction and expansion of roots are characteristic of: pneumonia, bronchitis and other chronic and inflammatory pathologies.

Pleural sinus

The pleural sinus is a cavity formed by pleural folds. The sinus is free in normal lungs, and, conversely, sealed in pulmonary pathology.

Fibrous tissue

The presence of fibrous tissue indicates that the patient has already suffered from pneumonia.

Spikes

The presence of adhesions indicates that the person had inflammation of the pleura in the past.

Calcifications

Safe dense round shadows. They say that the person had contact with someone who was sick: or pneumonia.

In other words, an infection entered the lungs, but it was localized and did not develop, and was isolated by deposits of calcium salts.

White is calcifications in the lungs (focal drawing)

Aperture changes

Changes in the diaphragm indicate an anomaly in its leaves. Usually this pathology develops due to poor genetics, deformation due to adhesions, excess weight, and past illnesses.

Focal shadows

Patch shadows are dark spots approximately 1 centimeter in size. It may indicate that it is tuberculosis or tuberculosis.

Displacement of the mediastinal shadow

The mediastinum is the space between the lungs and other organs. Enlargement indicates increased blood pressure, increased heart size, myocarditis or CHF.

Types of shading

Darkening with pneumonia

Pneumonia caused by Pseudomonas aeruginosa is characterized by an acute onset, severe general condition, high body temperature, shortness of breath, cyanosis, tachycardia, signs of intoxication, focal dullness of percussion sound, crepitus, and the presence of wheezing. Pneumonia can be complicated by pleurisy.

On fluorography of the chest organs, focal lesions (foci of inflammatory infiltration) are detected; in the case of abscess formation, cavities with a horizontal level are found, and in the presence of exudative pleurisy, intense homogeneous darkening is found. Pseudomonas aeruginosa is cultured from sputum, contents of the pleural cavity, and discharge from wounds.

Darkening with paragonimiasis

The initial stage of paragonimiasis occurs as an acute allergic disease. Changes are detected in the lungs (“volatile” infiltrates, pneumonia, pleurisy).

Allergic myocarditis and meningoencephalitis are quite often observed. Basically, the initial stage of the disease is asymptomatic. With the transition to the subacute and then to the chronic stage, changes in the lungs predominate: chest pain, cough with sputum, effusion in the pleural cavity, fever.

Later, fibrotic changes in the lungs develop; fluorograms reveal foci with characteristic radial darkening and light vacuoles in the center, areas of infiltration in the lung tissue, calcification, and sometimes diffuse pneumosclerosis.

Darkening with candidiasis

With a mild course of the disease, candiosis resembles the clinical picture of bronchitis. The x-ray reveals an increased bronchovascular pattern. In the later stages and in severe cases, pulmonary candidiasis manifests itself as focal or lobar pneumonia, and unstable “volatile” infiltrates are possible.

On fluorography there will be a spotty eclipse, which means small pneumonic foci, atelectasis. Sometimes miliary shadowing (“snow flakes”) occurs. Candidiasis pneumonia can be complicated by pleurisy.

Darkening with diffuse pneumosclerosis

Features of the clinical course of diffuse pneumosclerosis. Patients complain of cough with sputum production (as a result of concomitant bronchitis), shortness of breath, which first occurs during physical exertion, later at rest and finally becomes constant, general weakness, sometimes in the event of activation of the inflammatory process, fever appears. Upon examination, cyanosis (as a result of hypoventilation of the alveoli), swelling of the neck veins, and shortness of breath (symptoms of pulmonary heart failure) are revealed.

The chest may be compacted, but more often the presence of pathological airiness is determined by widened intercostal spaces - the emphysematous form of GC. The respiratory excursion of the lungs and the mobility of the lower pulmonary edge is limited. On percussion, as a result of concomitant pulmonary emphysema, a box sound is detected.

When auscultating the lungs, hard, sometimes weakened, vesicular breathing (with emphysema), dry and moist rales are heard. Using X-ray examination, increased transparency of the peripheral pulmonary fields in combination with severity, focal darkening and increased vascular pattern, and sometimes signs of bronchiectasis are determined.

Features of the clinical course of diffuse pneumosclerosis

A biochemical blood test reveals an increase in the content of alpha-2 and gamma globulins, fibrinogen; There is moderate proteinuria in the urine. X-ray of the respiratory organs allows us to identify eclipse of the corresponding segment/lobe of the lung and areas of infiltration. With gangrene of the lungs, pronounced signs of respiratory failure and intoxication are observed.

Darkening with fever

Complaints (remitting fever, chest pain, shortness of breath, cough with purulent sputum with an unpleasant odor in an amount from 200 ml to 1-2 liters per day, sweating). X-ray of the chest organs (large focal eclipse with uneven edges and unclear contours - in the infiltration phase and the presence of cavity formation syndrome with a horizontal fluid level in another period).

Darkening in cancer

Lung cancer is more common in men who are over 40 years old and long-term smokers. Against the background of eclipse of part of the lungs, there is mainly clearing, which indicates the collapse of the lung tissue, as well as bronchogenic focal metastasis to neighboring areas.

Darkening of exudative pleurisy

Very often, exudative pleurisy in the early stages of detection is considered as pneumonia, since they have many of the same symptoms. A small amount of fluid in the pleural cavity is often very difficult to determine from a fluorographic image.

In this case, complications are very easily resolved by ultrasound examination of the lungs, which detects 150-200 ml of effusion in the pleural cavity. In addition, exudative pleurisy is characterized by a specific cough with the release of mucous and purulent sputum.

In modern realities of medicine, radiography remains an informative and uncomplicated method. It is used in the diagnosis of diseases of the lungs, heart and other organs. Fluorography is used more often in detecting pulmonary pathology. This method is considered screening and publicly available.

Patients and doctors often encounter such an X-ray manifestation as darkening of the lungs on fluorography. What kind of clinical situation is this, what can it be associated with? The article also covers such issues as strengthening the pattern of the lungs, sclerosis of the aorta and its arch.

Darkening of the lungs on fluorography

First you need to understand that an x-ray is a negative image. The most convenient way to view and analyze it is with the help of a negatoscope - a special screen. Denser structures are light (white). The lower the density, the darker the image will be.

The lungs are a paired organ containing air and interstitial fluid, as well as blood vessels containing blood. In the picture these are dark fields. If there is a lighter area viewed in the image using a negatoscope, they speak of a focus or a dark spot, no matter how paradoxical this may sound.

What could it be?

Among all the emerging clinical and radiological situations, the fact when a fluorography study showed darkening is of particular importance. There are various variations of this phenomenon.

Extensive darkening in the lungs on fluorography. What it might be can only be judged after further examination. Such a change in the projection of the pulmonary fields can cause not only lung disease, but also damage to other organs of the chest: mediastinum, diaphragm, esophagus, lymphatic collectors.

The next possible pathology is a rounded lesion or focus of darkening. It can take the form of a circle, an oval structure, or an ellipse. It is important to understand in detail what darkening in the lungs means on oval-shaped fluorography. And again the doctor is faced with the question of the localization of the pathological formation or process.

Causes

There are many potential etiological factors for the described radiographic changes. It can be clarified after additional research.

When extensive darkening in the lungs is detected on fluorography, the causes should be sought using multi-projection x-ray techniques. If the mediastinal structures are displaced towards the shading focus, collapse of the lung, its absence (after pneumonectomy), as well as cirrhotic deformation of the lung tissue are suspected. The last situation differs from the first two in that the darkening itself is heterogeneous (non-uniform) in nature.

Sometimes the mediastinum and its structures are shifted to the opposite side. If a darkening is detected on fluorography, it is likely that this may be a large tumor formation or total hydrothorax, an accumulation of air in the pleural cavities.

The following conditions and diseases can be the causative factors for the occurrence of rounded darkening:

In doubtful cases, diagnostic examination is supplemented with tomographic techniques.

What does increased pulmonary pattern on x-ray mean?

The lungs have a heterogeneous structure. After all, this is a whole complex of structures:

alveoli;
bronchial tree;
veins;
arteries;
The lymph nodes;
nerve trunks and endings.

Possible depletion and strengthening of the pulmonary pattern on x-ray. What does it look like externally, and what diseases need to be excluded?

Increased pulmonary pattern on fluorography is more common. This term means that a unit area of the pulmonary field contains a larger than usual number of its constituent elements. At the same time, their size and diameter increase.

First of all, doctors think about inflammatory changes in the lungs. Moreover, it turns out in most cases that these are residual effects in the pulmonary structure after suffering inflammation. This happens after pneumonia and tuberculosis.

When the inflammatory mechanism for the appearance of an enhanced lung pattern is excluded, it is necessary to search for cardiac causes. The functional diagnostician thinks in this case about mitral defects. These are different types of violation normal operation valve that allows normal blood flow from the left atrium to the left ventricle. If fluorography reveals an increase in the pulmonary pattern from an early age, the probability of a correct hypothesis is quite high. Such a change in the pulmonary picture can cause both insufficiency and stenosis (narrowing) of the mitral valve.

A less possible cause is increased pressure in the pulmonary artery system. Pulmonary hypertension can only be diagnosed by a cardiologist, and echocardioscopy is necessary to confirm it.

What else can you see in the picture?

On x-ray or fluorography, in addition to darkening, clearing of the pulmonary field is revealed. At the same time, it looks darker than normal lung tissue. Deformation of the roots of the lung is also possible.

X-rays are important not only for excluding pulmonary pathology. They make it possible to detect pathological changes in the heart and large vessels.

Enlarged heart (expanded to the left)

Left ventricular hypertrophy occurs in almost every patient with arterial hypertension. Elevated blood pressure numbers, in turn, are detected in half of the population. Therefore, an enlarged heart is often detected on fluorography images.

The entire organ as a whole, as well as any individual cavity, can become enlarged. The configuration of the heart shadow will depend on this. It is this that will push the specialist to the right thought and allow him to build the correct clinical hypothesis.

An enlarged heart on fluorography is usually manifested by a change in the size of the left ventricle.

Changes in the posterior cardiophrenic angle (between the heart and the diaphragm) are detected. Under normal conditions this angle is acute. With hypertrophy of the left ventricle it becomes dull. Identification of the phenomenon indicates that the heart is enlarged to the left. Fluorography does not provide comprehensive information, so it is necessary to conduct an ultrasound examination to determine in more detail the sizes and volumes of the heart chambers.

Aortic seal

The shadow of the heart consists of two contours - right and left. Each of them reflects the structure of the heart cavities and efferent vessels. The upper part of the right contour and the larger half of the left are formed by the aorta and its branches.

Compaction of the aorta on fluorography indicates the presence of atherosclerosis.

We are talking about a metabolic disease, which is expressed in the accumulation of excess fat in the wall of blood vessels. It can cause strokes and heart attacks when the atherosclerotic plaque is destabilized. Compaction of the aortic arch during fluorography is a reason to prescribe a biochemical blood test to determine the concentration of cholesterol and its fractions. It can be supplemented with ultrasound techniques - ECHO-CG and ultrasound Dopplerography.

Sclerosis of the aortic arch

This is another commonly encountered radiological phenomenon. Sclerosis of the aortic arch during fluorography is considered a manifestation of systemic atherosclerosis.

If cholesterol plaques are detected during fluorography of the lungs, there is a high probability of damage to blood vessels in other locations. First of all, atherosclerotic changes in the coronary and renal arteries should be excluded.

Sclerosis of the aortic arch can be confirmed using ultrasound. For this purpose, echocardioscopy is used.

Useful video

Why you need to do fluorography can be found out in the following video:

Conclusion

Darkening in the lungs on fluorography, like other radiological signs, is a reason to expand the diagnostic search.
Only the correct interpretation of the image allows the doctor and the patient to make a preliminary diagnosis.
Detection of darkening in the lung on fluorography, strengthening of the pulmonary pattern serves as a reason for further additional examination: X-ray examination or computed x-ray tomography.

After fluorography, which doctors recommend at least once a year, various dark spots are often detected.

In this case, the best explanation can be obtained from your doctor. Most often, additional examination will be required to clarify the diagnosis, after which the real cause of these spots will be identified. The spots can be caused by a variety of diseases, ranging from pneumonia to lung cancer. However, ordinary defects in the image are also possible, which have nothing to do with medicine. Therefore, without taking into account the doctor’s opinion, no conclusions should be drawn.

Usually, in most lung diseases, there is an absence of lung tissue or its compaction, otherwise the compacted tissue absorbs the radiation emanating from the X-ray machine to a greater extent. This appears as a dark spot in the picture. The size of the damage determines the shape and size of the spot.

In addition, the darkening in the image can be explained by the presence of fluid accumulating in the pleural part.

What does the spot on the photo of the lungs indicate?

Spot on the picture may be caused by the consequences of pneumonia or bronchitis, since during the course of such diseases small nodules appear, but over time they resolve on their own. To confirm the fact of resorption, the study should be repeated a month later.

Which completely covers the upper parts of the lung, treatment is prescribed and, after confirming the diagnosis, mandatory drug treatment is prescribed. Scars, which appear on photographs as darkening, remain on the lungs due to tuberculosis.

Similar images can be obtained in acute or chronic pneumonia, but in this case, the shadows disappear over time.

If lung cancer is suspected, doctors select a piece of tissue for analysis, but this is a very complex and unpleasant procedure, which is carried out only in a hospital.

The image may also show foreign bodies lodged in the lungs, which occurs mainly in children. In this case, surgical intervention may be necessary.

The lungs also darken, but doctors can easily distinguish such signs.

Annual fluorography for adults is the unconditional standard for the diagnosis and prevention of chronic lung diseases.

Tuberculosis is the cause of the spot on the picture

This procedure has greatly helped in combating the spread of the terrible tuberculosis, although tuberculosis infection is still one of the most common diseases of the respiratory system in our time. The activity of Koch's bacillus can be easily detected by X-ray examination.

The greater the percentage of lungs affected by tuberculosis, the larger the spots, which can also be used to determine the destruction of lung tissue.

In tuberculosis, spots on the lungs are single or multiple, which indicates an infiltrative or disseminated form of tuberculosis.

When spots on the lungs are detected on the finished image and the results of the procedure are deciphered, the light areas are usually called “darkenings” and the dark ones “clearances.” To an untrained person, dark spots on the lungs appear as light areas on an X-ray. This is one of the reasons why only a specialist should make a diagnosis based on the image.

If spots are found on the x-ray, do not despair. The presence of darkening or flashing does not always indicate the development of serious diseases. Often the cause of the formation of spots is the poor quality of the fluoroscope. And even the incorrect position of the patient during the procedure also shows spots on the lung image. To find out the exact cause, you need to consult your doctor.

Studying the image

What do the spots mean?

White spotty formations on an x-ray of the lungs may be a consequence of the following diseases:

Inflammation of the lungs.
Bronchitis.
Tuberculosis.

If a patient has had pneumonia or bronchitis in the recent past, and an x-ray shows spots on the lungs, this means that residual effects of the disease are occurring in the body. With proper treatment, the nodules will soon resolve.

Spots on the photo

When diagnosing tuberculosis, light-colored formations will be located in the upper parts of the lungs. With proper treatment, the area of inflammation decreases. During the recovery stage, dark spots in the lungs will appear on x-ray, which indicates tissue scarring.

Dimming

If fluoroscopy shows dark or black spots, this may indicate a chronic form of pneumonia. As a rule, darkening appears in the acute stage. During the healing process, the darkening disappears.

Black spots on an x-ray of the lungs may indicate the development of cancer. However, no conclusions can be drawn based on fluoroscopy alone. To confirm or refute the diagnosis, the doctor prescribes a series of tests and additional examinations. If lung cancer is suspected, a complex analysis of lung tissue is prescribed, which is carried out in a hospital.

Darkening in the photo

Dark formations on an X-ray of the lungs, provided the patient is in relatively normal health, can confirm the fact of many years of smoking. In children, darkened areas on the image indicate the presence of a foreign body in the organ. In this case, surgical intervention is required.

White spots

Unfortunately, a bright spot on an x-ray of the lungs is not always a sign of residual effects of the disease.

Often, white formations in the image indicate the development of such ailments:

Inflammation.
Atelectasis.
Pathological processes in pleurisy.
The development of diseases associated with human professional activity.

If light spots are detected in the image, the doctor must prescribe a number of additional tests. Since any deviations from the norm must be clarified through a comprehensive examination of the patient. An experienced specialist will never make a diagnosis based on one analysis result. To identify the true cause, a radiologist can determine repeated fluoroscopy in different projections.

White spots

In the initial stage of tuberculosis, white formations also appear in the image. This process indicates primary tissue damage by pathogenic bacteria. An eloquent sign of tuberculosis at the first stage is a characteristic light path from the site of inflammation to the root system.

Pneumonia spots

To understand that the image showed the presence of pneumonia, the specialist must know what this pathology looks like. Spotty formations in pneumonia can have different locations and dimensions:

Small with limited margins up to 3 mm.
Segmental – located within the boundaries of a segment.
Subtotal – all fields, with the exception of the upper lobes.
Total formations covering the entire surface of the lungs.

As inflammation develops, white spots with unclear, blurred contours form in the lungs. In this case, the severity of the severity depends on the degree of development of the disease. The more advanced the disease, the more pronounced the spots in the picture.

Light spots

Summing up

If there are black or white spots on the X-ray image, additional examination is necessary. It is important to understand that if the radiographer’s work is poor, white and dark formations are only a side effect of the functioning of the device. To establish an accurate diagnosis, a specialist will definitely prescribe a series of examinations and tests. Only after receiving all the results, the doctor has the opportunity to assess the picture of the patient’s condition.

A white spot on an X-ray of the lungs with smooth, clear contours of medium intensity - such a conclusion from a radiologist is common. It reflects infiltrative changes in the lung tissue or “plus shadow” syndrome.

What to do if a white spot is detected on the x-ray

When performing a chest x-ray or fluorography in a patient with tuberculosis, a white spot on the x-ray reflects either an inflammatory lesion of the lung tissue or destructive changes in the parenchyma with the formation of abscesses, tubercles, and caverns. Correctly, this symptom should be called darkening, since it reflects the characteristics of the passage of x-rays through objects and their color display on the x-ray.

A white shadow in a photograph is also observed when:

pneumonia;
atelectasis;
exudative pleurisy;
occupational diseases (silicosis, talcosis, asbestosis).

Radiographs with white spots of various origins: 124.3 – breast piercing, 124.4 – shot in the soft tissues of the chest, 124.5 – professional cementosis, 124.6a – contrast during bronchography, 124.6b – pneumonic focus, 124.7 – interlobar pleurisy (arrows indicate artifact)

This syndrome is a sign of many pathological changes in the lungs, but we will consider the most common options.

If spots are detected, additional research is necessary to determine the cause of the pathology. For these purposes, a radiologist may prescribe an X-ray examination in additional projections or perform layer-by-layer computed tomography or magnetic resonance imaging.

What does a spot look like on an x-ray with pneumonia?

In pneumonia, the spot on the x-ray image has a length depending on the size of the lesion in the pulmonary parenchyma:

limited – up to 3 cm in diameter;
segmental – within a segment;
subtotal – the entire field, with the exception of the tops;
total.

Pneumonia is an inflammatory disease that affects the alveolar tissue with accumulation of fluid in the acini. Pathogenesis forms a specific x-ray picture of the disease.

X-ray. Focal pneumonia in the lower lobe on the right

The white spot with pneumonia has fuzzy, blurred contours. Its intensity can be low or high, depending on the characteristics of the exudate (inflammatory fluid in the lumen of the alveoli). A path from the root approaches the site of its localization due to lymphangitis.

Atelectasis of the lung or x-ray semiotics of triangular spots on the image

Lung atelectasis is a disease accompanied by the collapse of a segment, lobe or lung tissue completely against the background of cessation of bronchial ventilation. Radiologically, such changes are called limited darkening, since they do not extend beyond the segment or subsegment and have a triangular shape.

Atelectasis of the middle lobe of the right lung - frontal and lateral radiographs

How to identify atelectasis in an image:

the size of the spot coincides with the size of the changed segment;
triangular darkening in the lungs can be seen in frontal and lateral projections;
during inhalation photographs the size of the spot does not increase;
the narrow end of the triangular shadow is directed towards the root;
Holtzknecht-Jacobson symptoms are observed during fluoroscopy (suction of the mediastinum towards the lesion during exhalation).

The morphological substrate of the pathology is the accumulation of infiltrative fluid in the alveoli, infiltration of lung tissue, and tumor growth in the pulmonary parenchyma.

Spontaneous atelectasis occurs in 1-3% of patients due to a defect in surfactant (the substance that forms the framework of the alveoli).

Schematic representation of the topography of segmental atelectasis

Limited darkening during collapse of the lungs requires knowledge of the segmental structure of the lungs, as it reflects atelectasis of a certain segment. By establishing the topography of the shadow, the doctor can guess which bronchus is affected. The substrate of formation (infiltrate, additional tissue, exudate) is almost impossible to determine on the basis of a radiograph.

What does a white spot mean in a picture of tuberculosis?

In tuberculosis, a focal spot on a chest x-ray indicates the infiltrative stage of the disease, when mycobacteria begin to infect the lung tissue. In this case, the x-ray shows a path to the root from the side of the lesion (due to lymphangitis). Such radiological symptoms are called “primary tuberculosis focus”.

Radiographs at various types x tuberculosis

Multiple small disseminated shadows on both sides indicate miliary tuberculosis.

A single large shadow with a cavity inside (clearance) and a fluid level - an abscess formed against the background of destruction of the lung parenchyma - “ring shadow” syndrome.

A spot on an X-ray of the lungs in the projection of the pulmonary fields reflects a pathological process, the causes of which should be established by additional research.

During the annual medical examination, the patient is offered to undergo fluorography to check the condition of the lungs. The procedure involves obtaining an image of a person's internal organs when X-rays pass through the tissues of his body. Thanks to X-rays of the lungs, it is possible to diagnose in the early stages various diseases in the lung, the symptoms of which have not yet appeared in a person - tuberculosis, lung cancer, atelactase, etc.

What does a classic x-ray of the lungs look like?

Classic X-ray of the lungs

The human lungs look like this in the picture: the right and left lungs on the sides of the spine, the shadow of the heart, the collarbone, the ribs, the dome of the diaphragm. The images obtained are deciphered by specialists who assess the condition of the patient’s lungs according to the following scheme:

how the lungs are located in the chest relative to other organs;
number of pulmonary lobes;
the shape of the paired organ and its size;
pulmonary pattern.

The lung tissue of a healthy person has a homogeneous and uniform structure. In some cases, dark or light colored spots appear on x-rays. This may indicate both the presence of serious pathologies and physiological processes in the lungs that are not a deviation from the norm. However, having received such an image, the patient anxiously begins to look for information about the meaning of darkening or light circles in the image. What they mean will be explained below.

Reasons for the appearance of spots in the photo

There are many reasons for the appearance of dark spots on the lungs. When a pathological process affects an organ, its structure changes noticeably - areas with compactions appear, which, when exposed to X-rays, absorb rays in greater quantities than healthy tissue. This is why dark areas are visible in the pictures. These areas can vary in shape and size:

Focal darkening. Usually detected during inflammation and cancer processes in organ tissues. They look like small spots, up to 10 mm in diameter. Based on their presence, it is impossible to make a correct diagnosis. Additional studies are needed - CT scan, blood, urine and sputum tests.
Round shading. They are visualized as single round shadows. Usually they are an indicator of the inflammatory process in the lung tissue. This picture is indicative of pneumonia, abscesses, benign formations in this organ, bronchial asthma, and even rib fractures. Less commonly, round single dark spots indicate oncological processes in the lungs.
Segmental darkening. Localized in the shape of a triangle (triangles) on one or both lobes. They can be either single or multiple. Single segmental opacities may indicate a foreign object in the organ or tumors within the bronchi, which can be either benign or malignant. Multiple segments in the images indicate the presence of pneumonia, central lung cancer, narrowing of the central bronchus, pleurisy, and oncology of neighboring organs.
Darkening of fuzzy shape. These dark areas do not have definite contours and cannot be compared with geometric shapes. Most often, the presence of such darkened areas of uncertain shape indicates infectious lesions of the lung - staphylococcal pneumonia, exudative pleurisy.
Lobar darkening. These are clearly defined and clearly visible shadow boundaries in photographs, having curved, convex and other shapes. This type of darkening indicates chronic diseases in the bronchi.

What dark spots look like on an x-ray in various diseases

Spots in the lungs on x-rays may appear due to the following diseases:

Tuberculosis

With this disease, the upper parts of the organ are seriously affected. In the image, this is manifested by the presence of multiple darkened lesions of small size - up to 2 mm in diameter. In this case, foci can merge, forming larger locations.

Pneumonia

In pneumonia, the presence of dark areas is noted in the lower parts of the lung tissue. The symptoms of the disease will be most clearly visible in the photographs at the time of the development of the disease. Visually, this will be manifested by an increase in the root of the lung due to the infiltration process, a change in the pulmonary pattern, shadows with an indistinct, blurry contour and numerous spots of different diameters.

With pneumonia, on an X-ray of the lungs, these spots have unclear contours and a heterogeneous structure.

In addition to pneumonia, the presence of multiple lesions in the lower parts of the pulmonary lobes indicates the consequences of pneumonia or bronchitis. With complete recovery, these marks will disappear.

Lungs' cancer

Lung cancer is a life-threatening condition. Its manifestations can also be noticeable during fluorography or x-rays. It is worth noting that in the presence of formations up to 2 mm in diameter, x-rays will not be able to detect the tumor. It is visualized on photographs when it reaches a diameter of more than 3 mm. For accurate diagnosis, x-rays are performed in two projections at once - lateral and direct.

In the image, if cancer is suspected, the following signs can be detected: a shadow on the periphery of the lung with a vague and bumpy outline, a thin outline of rays around the cancer focus, a large white spot stands out against the background of a strong shadow - this is how the picture of tumor disintegration appears.

However, when diagnosing oncology, you should not rely only on the image. The patient is referred to specialists who take a tissue biopsy and conduct additional studies - MRI, CT of the organ - to make the correct diagnosis.

Pleurisy

Pleurisy is inflammation of the pulmonary lining. In this case, the darkening is not explained by obstruction of air in those zones. In this case, fluid accumulates in the cavities from the folds of the pleura.

In the presence of dry pleurisy, the dome of the diaphragm is raised upward and the lung tissue is opaque. With effusion pleurisy, the angle of the diaphragm is smoothed out due to the accumulation of fluid, the lower part of the lung is darkened by an oblique border.

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Smoker's lungs

Heavy smokers also show dark spots on fluorograms or x-rays. They are explained by the thickening of the pulmonary pattern and the formation of cavities in the bronchi. The roots of the lungs in smokers are blurred - it is difficult to determine their structural boundaries. The blurring of the contours of the roots is explained by an increase in the pulmonary vessels due to respiratory failure. In addition, the image of a heavy smoker can reveal bronchitis, tuberculosis, and lung tumors.

Presence of a foreign body in the lungs

Dark spots in the lungs can be caused by the presence of a foreign object in the lung tissue. This can most often be found in children who are careless with small objects. Unfortunately, it is not always possible to detect an object in the bronchi or lungs on an x-ray due to swelling of the organ, so endoscopy is preferable to x-rays.

Listed above are the main reasons for the appearance of dark spots on the lungs on X-rays. It is very important to know that the shadows in the image itself look like the lightest areas, because... these are negatives. And vice versa - enlightenments in this paired organ will be reflected in the negatives as the darkest fragments. It is impossible to understand the symptoms of the disease and make a correct diagnosis based only on photographs. This should be done by a qualified radiologist.

Quite often, to provide the most informative and accurate state of the respiratory organs, doctors prescribe such a common study as an x-ray. This procedure is often indicated in order to clarify the result of previously performed fluorography or based on the general clinical picture of the patient’s condition. For example, with certain lung diseases, the density of some lung tissues becomes increased. In the resulting images, each of which shows the condition of the lungs, similar phenomena are noted in the form of spots and darkening in the lungs on the X-ray.

If the patient is informed about the discovery of spots, the first reaction of most is fear, many think that this is a malignant formation. Cancer gives some darkening, but is far from the only reason for the appearance of spots. In order to avoid wasting unnecessary nerves, and also to begin to act as quickly as possible when blackouts are detected, it is worth studying their types, as well as becoming familiar with the main reasons for their occurrence.

Causes of spots on the received images

The main reasons for the appearance of spots or darkening in an x-ray photo can be the following causes of darkening in the lungs:

If such darkening is detected, doctors usually prescribe additional forms of examination. This is based precisely on large quantities reasons that can lead to their formation. Competent treatment is prescribed only after the nature of the formations and the causes of darkening in the lungs have been fully established. Normal symptoms and health status are taken into account.

When diagnosed with pneumonia, an x-ray is the only option to identify a serious illness.

What spots might there be in the picture?

In the process of conducting an additional medical examination and carefully studying the resulting images, the specialist evaluates the darkening according to the following parameters:

The location of the spot is the upper, lower or middle part of the lung. It can also be the outer, inner and middle lobe of this organ. This way you can get a clear picture of the disease;
The size makes it possible to determine the total area of pathology;
Level of expression. Based on this feature, the degree of density of the lesion present can be determined. The severity can be moderate, weak and intense;
General outline. Pay attention to whether the stain has smooth or uneven edges. Often on this basis it is possible to determine the nature of education.

In addition to the differences listed above, spots in the image can be classified according to other criteria. Doctors must take them into account in order to establish a more accurate diagnosis.

Spots and dark spots that occur in the lungs and trachea can be characterized by their location, but also by appearance and general shape. The distribution is as follows:

Share. The spot has a clear outline and can be particularly concave or significantly convex. Darkening can develop against the background of inflammation, cirrhosis or destruction. If a spot of this type is located in the middle or lower part of the lung, the doctor may suspect a malignant formation.
Focal. These are relatively small centimeter-sized formations that can prove the presence of inflammation, the development of pathology of veins and blood vessels, as well as the development of peripheral cancer, dangerous tuberculosis and sudden pulmonary infarction. If such lesions were found against the background of headache, cough and pain, bronchial pneumonia can be judged.
Indefinite in form. These are special spots that do not have a bright expression or outline. To give the patient the most accurate diagnosis, more modern types of examination, such as CT or MRI, are prescribed. Such white spots often indicate pathologies such as pleurisy, pneumonia, hemorrhage, as well as various types of tumors. The diagnosis is clarified not only with the help of CT, but also by laboratory tests.
Liquid. This is direct evidence of pulmonary edema. The fluid collected in the lungs may be due to increased pressure in numerous vessels and the degree of permeability of their alveolar wall. In this case, the liquid immediately enters the lung tissue, disrupting their functionality.
Segmental. We are talking about darkening in the form of a triangle. This is evidence of pathologies such as a cancerous tumor, various benign formations, pneumonia, the presence of metastases coming from other organs, tuberculosis and fluid accumulation. The doctor’s competence is very important here, since the earlier measures are taken, the greater the chance the patient will have if a fatal pathology is detected.
Focus. As a rule, these are single spots, the size of which is on average 1 cm. Such lesions occur against the background of pneumonia, with increased fluid content in the organs, breathing, tuberculosis, and they can also be cysts and purulent abscesses.

Making an accurate diagnosis based on the type and location of spots alone is impossible. It is for this reason that additional high-quality examination is required.

If darkening is visible in the image, you should immediately consult a doctor who can identify or exclude the presence of a dangerous disease.

Decoding of received images

A few minutes after the fluorography office, a person receives a picture and its detailed transcript. Comments on the image may contain the following information in the form of medical terms, each of which characterizes certain health problems:

Enlargement of the roots of the right or left lung, which may indicate bronchitis or pneumonia; Heavy roots are special pathological changes that occur due to smoking or acute bronchitis;
The presence of an in-depth pattern of the vessels of the right or left lung indicates a violation of blood circulation in the respiratory organs, various problems with blood vessels and the heart, bronchitis, as well as inflammation in the lungs, which may be the initial stage of the oncological process;
Fibrosis and fibrous tissue are a consequence of previous surgical interventions and injuries;
Focal shadows, which are specific shadows. If such shadows are accompanied by an increase in the general vascular pattern, the doctor can judge pneumonia;
Calcifications of the right or left lung - means that the person had contact with a patient with tuberculosis. At the same time, the healthy body of an uninfected person encloses the rod in a calcium shell. It is the power of immunity that prevents the spread of infection;
Changes in the diaphragm - all this can be the consequences of problems such as obesity, pleurisy, diseases of the gastrointestinal tract.

Spots and dark spots found in the image can be evidence of several dozen different diseases; it is for this reason that after the x-ray it is necessary to continue a high-quality medical examination of the right or left lung.

Follow-up examination

To conduct further examination, the doctor may send the patient to a pulmonologist or oncologist, where he will be shown to undergo certain specific procedures. Here are the most common ones:

This may be a diaskintest, which can determine the presence of tuberculosis. If we compare this procedure with Mantoux, which quite often gives a false and inaccurate result, such an examination does not respond to BCG, which often shows a complete absence of a problem in the child. This is an ideal opportunity to diagnose tuberculosis as accurately as possible.
The study of sputum of children and adults is another mandatory analysis that is carried out in the laboratory. Based on the results obtained, it is possible to detect tubercle bacilli, the presence of malignant cells, as well as various impurities that may be characteristic of certain pathological conditions.
Quite often, doctors prescribe a more modern examination method - computed tomography of the lungs. This is an additional, informative method for diagnosing diseases of the lung tissue, pleura and mediastinum. It turned out that this is the most reliable method.
Lung bronchoscopy or tracheobronchoscopy may also be used. This procedure is performed using medical endoscopes that are quite flexible in design and are inserted through the nose. Through this form of examination, you can see the lungs and also take material, completely painlessly. The collected material, as a rule, is subjected to subsequent diagnostics - bacterial, histological and cytological.

If a doctor suspects lung cancer based on an x-ray, a tumor marker test may be prescribed. The analysis makes it possible to detect specific proteins that are usually produced by emerging malignant tumors.

Summing up

If darkening or light spots are found in the picture, do not panic when you see the picture. The best solution in this case would be to strictly follow the doctor’s recommendations. The specialist will conduct a more detailed additional examination to clarify the diagnosis. This is the only way to develop the highest quality treatment, take timely measures and thereby prevent quite serious complications.