Lung collapse artefact

Case contributed by Dr Praveen Jha

Presentation

Known case of bronchial asthma and COPD, comes with acute exacerbation

Patient Data

Age: 70 years
Gender: Female
Modality: X-ray

Features of right upper lobe collapse (homogenous density with elevated horizontal fissure)

Immediately CT was done to assess right upper lobe collapse, and then whole night, I was receiving calls on my representation / misrepresentation of images and CT-Chest X-RAY discordance.

Modality: CT

Senile barrel chest deformity seen with marked AP expansion of lower thoracic cage. No upper lobe collapse is seen. Finding of upper lobe collapse on chest radiograph is being discarded as projectional artefact.

Case Discussion

In the night, I could only see the CT images, and snubbed it off as emphysematous lung with senile chest deformity. Then, the medicine resident on-duty made me repeated calls about chest x-ray, which showed obvious collapse. In morning, we repeated chest x-ray and CT both. Findings were same, presented here.

It was concluded that, it might be a projectional artefact due to deformed thoracic cage, and apical pleural thickening. In retrospect, if we see, some symmetrical upper lobe haze is also seen on left side.

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Case Information

rID: 16672
Case created: 8th Feb 2012
Last edited: 15th Jan 2016
System: Chest
Inclusion in quiz mode: Included

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