Inferior accessory fissure

Case contributed by Ashesh Ishwarlal Ranchod
Diagnosis certain

Presentation

Acute dyspnea and non-productive cough. No prior history of asthma.

Patient Data

Age: 20 years
Gender: Male
x-ray

Mildly hyperinflated but clear lung fields.Normal CTR. Mild left-sided tracheal deviation due to asymmetric position at the time of exposure. Incidental right inferior accessory fissure.Overlying oxygen tubing.

Annotated image

Zoomed image of the right base with arrows demarcating the right inferior accessory fissure. The reverse window also assists in delineating the accessory fissure.

Case Discussion

The inferior accessory fissure of the lung (also known as Twining's line) is five times more common on the right in comparison to the left. It separates the medial basal segment from the rest of the lower lobe.

This patient was referred for a workup for possible asthma.

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