Round atelectasis

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Retired. Previous exposure to asbestos. Chronic shortness of breath.

Patient Data

Age: 65 years
Gender: Male
ct

Diffuse bilateral pleural plaques, some of which are part calcified.   The pleural thickening includes both medial basal segments of the lower thoracic cavity.

Bilateral lower lobe subpleural 'masses' with indrawing of the pulmonary vasculature.

No fibrosis.  No air trapping.

The mediastinum is normal in appearance.

Annotated image

An illustration to show round atelectasis.

https://radiopaedia.org/cases/pleural-thickening-illustrations

Case Discussion

Diffuse pleural plaque disease in keeping with prior asbestos exposure.

The bilateral lower lobe subpleural masses were present on a prior CT and unchanged.   The indrawing of the sub-segmental pulmonary vasculature towards the mass in the context of pleural thickening is typical of round atelectasis.  A crows feet appearance has been described for these appearances of vasculature indrawing.

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