Hemithorax white-out

Case contributed by Ian Bickle
Diagnosis certain


Elderly female with a prior history of malignancy. Short of breath.

Patient Data

Age: 70 years
Gender: Female

Chest radiograph


Complete opacification of the right hemithorax.

The trachea remains in the midline.  No mediastinal shift.

Left lung clear.

Case Discussion

Classical appearances of a complete white out of the hemithorax.

In this case it was due to a large pleural effusion with underlying lung collapse, hence no mediastinal shift.

The combination of 'push' from the effusion and 'pull' from the collapse has resulted in the trachea staying in the midline.

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