Left upper lobe collapse - hilar lung cancer

Case contributed by Dr Charlie Chia-Tsong Hsu

Presentation

Shortness of breath. Smoker.

Patient Data

Age: 45 years
Gender: Male
X-ray

Chest radiographs

Frontal (figure 1) and lateral chest (figure 2) radiographs demonstrate increased opacity in the left mid and upper zones with associated lucency surrounding the aortic arch/knuckle: Luftsichel sign. The lateral projection shows the anterior displacement of the oblique fissure. The left hilum and hemidiaphragm are elevated compatible with volume loss. There is also an additional density in the left hilum with a convex and well-defined lateral margin. Overall imaging appearance is classic for left upper lobe collapse secondary to left hilar mass concerning for central lung malignancy.

Annotated image

Chest radiographs (annotated)

Frontal (figure 1) and lateral chest (figure 2) radiographs demonstrate increased opacity in the left mid and upper zone with associated lucency surrounding the aortic arch/knuckle: Luftsichel sign (dotted red line). The lateral projection shows the anterior displacement of the oblique fissure (red arrows). The left hilum and hemidiaphragm are elevated compatible with volume loss. There is also an additional density in the left hilum with a convex and well-defined lateral margin (yellow star). Overall imaging appearance is classic for left upper lobe collapse secondary to left hilar mass concerning for central lung malignancy.

CT

18FDG-PET/CT

18F-FDG PET/CT confirms the presence of left upper lobe collapse secondary to an FDG avid left hilar mass causing bronchial obstruction/compression. Endobronchial biopsy of this lesion confirmed the diagnosis of squamous cell carcinoma.  

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Case information

rID: 35263
Published: 30th Mar 2015
Last edited: 16th Dec 2018
System: Chest
Inclusion in quiz mode: Included

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