Presentation
Shortness of breath
Patient Data
There is increased lucency in the right upper lung zone with reduced pulmonary vascular markings.
Extensive emphysematous changes bilaterally with bullous disease of the right lung.
Case Discussion
This patient has bilateral emphysematous disease. There is bullous formation and marked parenchymal destruction in the right lung, creating the appearance of a hyperlucent lung.
Differential considerations for a unilateral hyperlucent lung include the following, as per the CRAWLS mnemonic (not all are pertinent to this case) 1 :
C – Contralateral lung increased density, e.g. pleural effusion
R – Rotation
A – Air, e.g. pneumothorax
W – Chest wall mass/abnormality, e.g. Poland syndrome
L – Lungs, e.g. airway obstruction, Swyer-James syndrome, unilateral large bullae
S – Scoliosis
Case submitted by Dr. N. Larocque.
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