This 51 year-old female patient presented with bone pain and dyspnoea. The PA chest xray above shows an absent right breast shadow, dense bones, a right pleural effusion, and a reticular interstitial infiltrate. Note also the abnormal appearance of the right axilla, suggesting previous lymph node clearance. The findings are consistent with metastatic breast carcinoma with sclerotic bone metastases and lymphangitis carcinomatosis. The pleural effusion may be secondary to pleural or pulmonary metastases.

Credit: Dr Laughlin Dawes