Shortness of breath.
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Mild emphysema. Pleural thickening and pleural calcifications bilaterally. Trace left and small right effusions. Round atelectasis in the bilateral lower lobes, best appreciated on the sagittal reformatted images (characterized by swirled appearance).
Characteristic appearance of round atelectasis in the setting of asbestos-related pleural disease. In this case, the characteristic swirling of atelectatic lung parenchyma related to scarring of the parietal pleura is well appreciated on both axial images and sagittal reformats.
Patients with a history of asbestos exposure are also increased risk of lung cancer, and careful evaluation is required when rounded atelectasis is suspected. In this case, the findings have been stable for several years.
Rounded atelectasis can be diagnosed when the following are present 1:
- round or oval shape
- peripheral in location and abutting the pleural surface
- curving of pulmonary vessels or bronchi into the edge of the lesion
- ipsilateral pleural effusion or thickening
- Webb RW, et al. High Resolution CT of the Lung. 5th edition. 2015 Wolters Kluwer Health.