Loculated pneumothorax

Case contributed by Bruno Di Muzio
Diagnosis certain


Shortness of breath.

Patient Data

Age: 75 years
Gender: Male

Chest radiograph


Lung architectural distortion due to emphysematous changes. Large lucent areas along the right hemithorax lower zones and mediastinal margins in keeping with pneumothorax. There is tension with leftward shift of the mediastinum. 

CT Chest


The lucent areas likely represent loculated pneumothorax rather than large bullae. It is difficult to ascertain if this is acute or longstanding given the history of multiple prior pneumothoraces and pleural thickening and scarring. There is distortion of the background lungs due to emphysema. 

Case Discussion

Loculated pneumothorax in a patient with severe pulmonary emphysema and multiple prior presentations with pneumothoraces. The main differential of this appearance are subpleural bullous spaces

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