Presentation
Cough and shortness of breath.
Patient Data
There is complete opacification of the left hemithorax with findings of volume loss such as shift of the mediastinum to the left and elevation of the left hemidiaphragm, indicating that the left lung is atelectatic. There is abrupt "cut off" of the left main bronchus, suggesting that the bronchus is obstructed.
Left lung mass invades and occludes the left bronchus, with subsequent complete atelectasis left lung. The left pulmonary artery is encased and the left superior and inferior pulmonary veins are occluded. Small left pleural effusion. Multiple right lung nodules are likely metastases to the contralateral lung.
Case Discussion
The two most common reasons for complete opacification of a hemithorax are complete atelectasis of a lung and a massive pleural effusion. This case illustrates characteristic features of "white out" due to atelectasis, in this case due to lung cancer obstructing the left main bronchus. Mediastinal shift toward the atelectatic lung and elevation of the diaphragm are especially well seen on the coronal images.
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