Left lung aplasia

Case contributed by Dr Henry Knipe

Presentation

Long-standing shortness of breath.

Patient Data

Age: 40
Gender: Female
X-ray

Opacity affecting the left hemithorax with the mediastinum shifted to the left. Hyperexpansion of the right lung into the left hemithorax in keeping with patient's history of pulmonary aplasia. Prominent pulmonary vasculature. 

CT

Left lung aplasia is noted with a small bud. Hyperinflation of the right lung, which crosses the midline. Cardiomegaly and enlarged pulmonary trunk and pulmonary arteries in keeping with pulmonary arterial hypertension. 

Nuclear medicine

VQ scan

The left lung is not visualized consistent with the patient's history of a aplastic left lung. The right lung appears expanded with lung tissue extending across the thoracic midline. The ventilation images demonstrate mild heterogeneity in distribution of tracer. The perfusion images demonstrate homogenous distribution of tracer, with no unmatched perfusion defects identified.     

Case Discussion

Pulmonary aplasia is a rare congenital pathology in which there is unilateral or bilateral absence of lung tissue. It is distinguished from pulmonary agenesis, although similar, the main difference being that there is a short-blind ending bronchus in aplasia.

From Radiopaedia.org article: pulmonary aplasia

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Case information

rID: 32242
Published: 21st Nov 2014
Last edited: 3rd Jun 2019
System: Chest
Inclusion in quiz mode: Included

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