Left lower lobe collapse

Case contributed by Frank Gaillard
Diagnosis almost certain

Presentation

Shortness of breath.

Patient Data

Age: Adult
Gender: Female

Frontal chest x-ray

x-ray

The retrocardiac part of the left lung is increased in density and the outline of the descending aorta is lost. In addition there is loss of the medial part of the left hemidiaphragm. A double contour to the left edge of the heart is visible. 

Lateral chest x-ray

x-ray

Lateral projection demonstrates posterior deviation of the oblique fissure, opacity of the left lower zone and obliteration of the normal outline of the left hemidiaphragm. 

Annotated x-rays

Annotated image

The left lower lobe is reduced in volume and opaque. On lateral projection the oblique fissure is displaced posteriorly, and on frontal projection can be seen as a double heart contour (orange arrows). In addition there is loss of the left hemidiaphragm and descending aortic outline (blue dashed). 

Case Discussion

Lobar collapse is often not complete. This is due to either the presence of a degree of consolidation or an intrinsic abnormality of the underlying lung resulting in decreased compliance (or both). 

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