Atelectasis

Clinical presentation:

Middle aged man, smoker, with recent onset of cough.

The Image

Features in the Image

The heart is displaced towards the left. There is loss of the usual silhouette of the left hemidiaphragm. A triangular density lies behind the heart on the left side. The upper zone vessels can be traced into this density and the basal artery is not visible. There is lobulated widening of the upper mediastinum, obscuring the normal margins of the aortic arch.

General Features in Atalectasis

Subsegmental collapse shows linear densities, usually at the basis. It is common post-operatively and is seen with diminished respiratory activity.

In lobar collapse, as seen here, the key sign is shift of fissures. Also seen are mediastinal shift, elevated hemidiaphragm, hilar displacement, compensatory overinflation of the uninvolved lung, increased density (airlessness) and crowding of bronchovascular markings.

In complete lung collapse, you'll see complete lung whiteout, mediastinal shift, small volume in the hemithorax and diaphragmatic elevation.

Diagnosis

Collapse left lower lobe, Ca. bronchus, mediastinal lymphadenopathy.

Poor bastard!

Back to Case 2: Interstitial Disease

Forward to Case 4: Pleural Effusion

Return to Radiology for Medical Students Index

This page hosted by Get your own Free Homepage