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Bullous emphysema

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Increasing shortness of breath.

Patient Data

Age: 70 years
Gender: Male

Chest x-ray

x-ray

The mid and upper  zones of both lungs are markedly hyperlucent, with splayed pulmonary vasculature suggesting bullae. The lower zones demonstrate crowding of the pulmonary / vascular markings. A right sided pleural effusion has developed with dependent patchy atelectasis. The heart is at the upper limit of normal.

Case Discussion

This patient has extravagant apical bullous emphysema. 

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