What is the structural change visible in the LEFT upper lobe?
Parallel opaque lines represent the walls of dilated bronchi consistent with bronchiectasis.
What is particular about the mass like opacity in the RIGHT upper lobe and what diagnosis does this suggest?
The opacity is branching and appears tubular, and thus likely represent opacification of right upper lobe bronchiectasis. This is most likely due to trapped mucous and in a patient with long standing wheeze, most likely represents allergic bronchopulmonary aspergillosis (ABPA).
What is the term used to describe the appearance of these pacified expanded bronchi?
Finger in glove sign.
How would you confirm the radiological diagnosis?
CT of the chest would be useful in confirming bronchiectasis and mucous plugging.
Chest x-ray demonstrates tubular branching opacities in the right upper lobe. In the left upper lobe a number of parallel lines extending from the hilum (tram track) suggest bronchiectasis.