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Hemithorax white-out - lung collapse

Case contributed by Assoc Prof Frank Gaillard

Chest radiograph

X-ray

Total white-out of the right hemithorax with tracheal deviation to the right. 

Case Discussion

CT confirmed total collapse secondary to a T4N3M1 lung tumor.

White-out of the hemithorax on CXR has a limited number of causes. The differential diagnosis can be shortened further with one simple observation - the position of the trachea. Is it central, pulled or pushed from the side of opacification?

  • pulled: pneumonectomy, total lung collapse, pulmonary agenesis
  • central: consolidation, mesothelioma
  • pushed: pleural effusion, diaphragmatic hernia

Case credit: Dr Ian Bickle

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