Presentation
Sudden onset of sharp left-sided chest pain. Tachypneic with desaturation.
Patient Data
There is a hyperlucency in the left upper zone suggestive of a bulla. There is a left-sided pneumothorax.
Moderate left-sided pneumothorax is most voluminous at the left lung base anteriorly. Note is made of mediastinal shift to the right.
There is extensive centrilobular and paraseptal emphysema most pronounced at the upper lobes bilaterally. A cystic lesion within the left hemithorax anteriorly and superiorly likely represents an exophytic bulla.
A calcified granuloma is noted in the right upper lobe.
Case Discussion
Plain radiographs and CT show a left-sided pneumothorax, a large bulla and emphysematous changes.