Differential Diagnosis for Wedged Shaped Opacity Arising from the Left Hilum/Mediastinum on X-ray
- Single Most Likely Diagnosis
- Pulmonary embolism with infarction: This is a common cause of a wedge-shaped opacity, especially if it arises from the hilum and is associated with symptoms such as sudden onset of chest pain and shortness of breath.
- Other Likely Diagnoses
- Lung cancer: Tumors can present as a wedge-shaped opacity, especially if they are located centrally and invade or compress adjacent lung tissue.
- Pulmonary metastasis: Similar to primary lung cancer, metastatic lesions can cause wedge-shaped opacities, particularly if they are located near the hilum.
- Lymphadenopathy: Enlarged lymph nodes in the mediastinum or hilum can cause a wedge-shaped appearance on X-ray, especially if they are due to infection, inflammation, or malignancy.
- Do Not Miss Diagnoses
- Aortic dissection: Although less common, an aortic dissection can cause a wedge-shaped opacity if it involves the mediastinum and compresses or invades adjacent lung tissue. This is a medical emergency.
- Mediastinal hematoma: Bleeding into the mediastinum, which could be traumatic or spontaneous, can cause a rapidly expanding mass that might appear as a wedge-shaped opacity on X-ray.
- Rare Diagnoses
- Diaphragmatic hernia: A rare condition where abdominal contents herniate into the thoracic cavity, potentially causing a wedge-shaped opacity if the hernia is large enough and involves the mediastinum or hilum.
- Foregut duplication cysts: These are rare congenital anomalies that can present as a mass in the mediastinum and potentially cause a wedge-shaped opacity on X-ray if they become large enough or infected.
- Mediastinal fibrosis: A rare condition characterized by the deposition of collagen and fibrous tissue within the mediastinum, which can cause masses or opacities that might appear wedge-shaped on X-ray.