Today I am presenting chest radiographs of a 66-year-old man with cough and low-grade fever.
What would be your diagnosis?
1. Pleural effusion
2. Lobar collapse
4. Any of the above
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Findings: PA radiograph shows a descended left hilum (A, arrow). There is a triangular retrocardiac opacity (C, red arrow) and blunting of the left costophrenic angle (A, yellow arrow). These findings are typical of LLL collapse, as many of you mentioned (see Diploma case 63).
The lateral view shows a posterior triangular shadow (B, arrow) which represents the collapsed LLL.
Coronal CT confirms the triangular shaped LLL collapse (C, red arrow), causing elevation of the left hemidiaphragm (C, arrows). There is no evidence of pleural effusion.
Axial CTs show a mass at the origin of the LLL bronchus (D-E, arrows). Note the markedly collapsed LLL (D-E, red arrows).
Bronchoscopy and biopsy confirmed the diagnosis of carcinoma.
Final diagnosis: carcinoma with LLL collapse
Congratulations to the great majority who made the diagnosis of LLL collapse. Ruqqayia was the first and deserves to be mentioned.
Teaching point: there is little to teach in this case because most of you made the diagnosis. Not everybody is so knowledgeable, though: this patient was seen in the Emergency Room of a large hospital and was told by the attending physician that his chest was unremarkable. Films were rescued by the radiologist the morning after and CT ordered.
16 thoughts on “New Webinar Prof. Cáceres! Tuesday 18 December – SOLVED”
Left lower lob collapse
Hi mr Pepe
I was the first mentioned 😊😊
My most abject apologies. To compensate my mistake, I am sending you a dedicated picture by mail. Treasure it. It will be worth hundreds of euros in the near future!
Thank u. I appreciate this from u 🤗🤗 hope we will meet i future
Left lower lobe collapse
Loss of volumen of the left hemithorax. Obliteration of the left principal bronchi with inferior lobar collapse.
In the lateral view there is an anterior displacement of the trachea and in the PA is displaced towards the left side so partial superior lobar collapse is associated.
I think in tumoral hiliar pathology.
Lobar collapse (left lower lobe)
Left lower lobe collaspe
Widened right paratracheal line
Loss of vol left due to collapse lower lobe and segmental collapse upper lobe.
Rt paratracheal thickening.
Left dome ?pushed down