Right middle and lower lobe collapse, secondary to endobronchial non-small cell lung cancer
Presentation
Persistent cough. Smoker.
Patient Data
Middle and right lower lobe collapse, volume loss and a mass at the right hilum. The right heart border is abnormal.
Previous Chest X-rays
Previous chest x-rays.
PA radiograph 13 years ago is normal.
PA radiograph taken 3 months previously reveals right middle and lower lobe collapse, volume loss and a mass at the right hilum. The right heart border is abnormal.
Subsequent CT
CT study confirms complete collapse of the middle and right lower lobe with low attenuation mucus seen to plug the airways. There is a mass obstructing the proximal right lower lobe bronchus.
The sagittal sections on lung windows make identification of the fissures very simple and therefore aid identification of the exact collapsed lobe.
Note also the widespread emphysematous changes secondary to smoking.
Case Discussion
This is a classic case of a middle and right lower lobe collapse secondary to an endobronchial mass. The CT confirms the findings but all the signs are in fact visible on the chest x-ray. Biopsy confirmed non-small cell lung cancer as the cause.
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