Presentation
History of tuberculosis treated one year ago. Shortness of breath.
Patient Data
Progression of the degree of upper lobe collapse now with complete left upper lobe collapse. A small persisting cavity is seen within the left upper lobe. Irregular nodular opacities and interstitial opacity is seen in the apical segment of the left lower lobe. Volume loss is seen in the left hemithorax with elevation and tenting of the left hemidiaphragm and deviation of the mediastinum towards the left.
The right lung and pleural space are clear.
The heart is displaced towards the left with adjacent hazy increased density consistent with pectus excavatum.
There is left upper lobe collapse with a left apical cavitary region measuring about 2.5 centimeters diameter without internal fluid level or grossly thickened margins. There is bronchiectasis involving the left upper lobe as well as the apical segment of the left lower lobe. Several foci of linear and nodular opacity, probably relating to scarring are seen within the apical left lower lobe. There is some minor groundglass opacification within the hyperexpanded right lung that is predominantly dependent.
No pleural effusion. No pneumothorax. The no axillary or mediastinal lymphadenopathy. Limited upper abdominal imaging unremarkable. No suspicious bony abnormality seen.
Case Discussion
This case demonstrates scarring features of previous lung TB infection in the left upper lobe, with left upper lobe collapse.
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