Giant pulmonary bulla
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Massive focal lucency in the right lung with an absence of lung markings and some mild mass effect on adjacent lung parenchyma. The minor fissure is displaced superiorly and there is increased right hemithoracic volume. The left lung demonstrates increased perihilar markings. No evidence of pneumothorax.
This patient was a long term smoker and a subsequent CT (not available) confirmed asymmetric bullous emphysema. Initially, this CXR was misdiagnosed as a pneumothorax.