Presentation
Recurrent pneumonia, breathlessness. Previous chest radiograph showed possible diaphragmatic hernia.
Patient Data
Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.
Large cystic areas in right hemithorax with some of them showing air-fluid levels, with contralateral mediastinal shift. Diaphragmatic outline is not well visualized on right side. Possibility of diaphragmatic hernia was being considered.
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![This study is a stack](/packs/stack-YQKLCKBI.gif)
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Multiple cystic areas of varying sizes, reaching up to 8 cm in size are seen replacing most of the lung parenchyma. Residual lung parenchyma appears compressed and atelectatic. Contralateral tracheomediastinal shift is seen. Diaphragmatic continuity appears intact.
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A post-contrast radiograph taken, also shows above mentioned findings.
Case Discussion
Congenital pulmonary airway malformation type I, has large cystic areas, which may have air-fluid levels. Also, these large cysts may produce mass effect and mediastinal shift, which may be confused with congenital diaphragmatic hernia on a radiograph. Cross-sectional imaging helps in this regard.
(Case courtesy: Dr. Abhijit Yadav, Dr. B L Yadav center for diagnostic imaging and research).