The first impression when looking at the PA chest radiograph is a prominent left hilum red arrow. All these are typical signs of left upper lobe collapse. Diagnosis is confirmed on the lateral view, which shows a thin line behind the sternum arrows , representing the left major fissure displaced anteriorly due to the marked loss of volume of the left upper lobe.
Once the collapse is recognised, carcinoma of the lung is by far the most likely diagnosis, since the majority of collapses of the left upper lobe are due to carcinomas. An interesting fact is that this patient had a CT one year earlier, read as normal. Review of the CT shows the endobronchial tumour arrow and moderate loss of volume of left upper lobe in the sagital reconstruction arrows , both overlooked at that time. Teaching point: important to know and recognise, says the muppet the signs of left upper lobe collapse because the great majority of them are due to endobronchial carcinoma Be Sociable, Share!
On PA chest: opacity- post rib6 right,and between left. Patchy consolidations appear in RUZ and then coalesce to form a relatively sharp edge that conforms to the treatment portals rather than to anatomic boundaries.
Thanks in advance! Dear Wisper in the wind, I think you describe very well the findings. All you have to do now is to put two and two together. Sorry, I cannot keep on because I do not want to give away the diagnosis. Keep up the good work. Dear friends, i am very pleased with your answers. Some are right and others are not. Perhaps is too early to post the final diagnosis.
Do not want to spoil the chances of the late comers. Anyhow, i would exclude the diagnosis of pulmonary hypertension. Basic findings in PH are prominent hila, enlarged main pulmonary arteries and cut off of peripheral arteries.
