. Radio-diagnosis of pleuro-pulmonary affection . , cuts through the center of the right hemithorax in its entire width. Be-sides considerable enlargement of the right hilus shadow, attached to the medianshadow (tuberculosis of hilus) and diffuse shadows in both lungs, more markedand more extensive on the right (pulmonary lesions). CIRCUMSCRIBED AND ENCYSTED PLEURISY 43 and rales; now and then moist explosive expiratory the base the vesicular murmur had disappeared; nosounds; no rales; no egophony; no aphonic pectoriloquy. Radioscopic examination showed a diffuse obscurity of thewhole
. Radio-diagnosis of pleuro-pulmonary affection . , cuts through the center of the right hemithorax in its entire width. Be-sides considerable enlargement of the right hilus shadow, attached to the medianshadow (tuberculosis of hilus) and diffuse shadows in both lungs, more markedand more extensive on the right (pulmonary lesions). CIRCUMSCRIBED AND ENCYSTED PLEURISY 43 and rales; now and then moist explosive expiratory the base the vesicular murmur had disappeared; nosounds; no rales; no egophony; no aphonic pectoriloquy. Radioscopic examination showed a diffuse obscurity of thewhole left chest, greatest at the apex and base. Towardsthe apex the obscurity extended to the upper two-thirds ofthe chest; it was dense but not homogeneous, and in thecenter of the opaque zone there was distinguished a small,irregularly rounded clear area, the size of a walnut, whichsuggested a pulmonary cavity. At the base the obscuritywas less extensive but more homogeneous and more was continuous with the shadow of the heart, occupied. Fig. 8. LEFT DIAPHRAGMATIC PLEURISY all the inferior external side of the hemithorax, and com-pletely effaced the costodiaphragmatic cul-de-sac. Thediaphragm was totally immobilized on this side and norespiratory movement was perceptible. This shadow, however, did not show a clearly defined uppercontour. It was gradually effaced, continuing imperceptiblywith the gray tone of the lung above, almost giving the im-pression of a pleurisy of the large cavity in process of absorp-tion; but the findings obtained by clinical examination didnot favor this interpretation. Autopsy showed that it was an encysted serous diaphrag- 44 RADIO-DL\GNOSIS: PLEURA matic pleurisy, added to extensive pulmonary tuberculouslesions, with a small cavity, as radioscopic examination hadindicated. Solid and complete obscurity of the base in tuberculouscases with effacement of the costodiaphragmatic cul-de-sacought to be suspected, especially when on clinical examin
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