The chest radiograph in primary liver cancer: an analysis of 449 cases.

The value of plain chest radiography in the diagnosis of primary hepatocellular cancer (PHC) was assessed in 449 patients. An elevated right hemidiaphragm and pulmonary metastases were present in 11% and strongly suggest a diagnosis of PHC. In all, the right hemidiaphragm was raised in 30% of patients. Pulmonary metastases were present on admission in 19% of patients and appeared later in a further 6%. Secondary deposits were found in the lungs at necropsy in 52% of patients, compared with only 24% in whom there was radiological evidence of metastases during life. In 36% of patients chest radiographs were normal on admission.