ICD Case 2

Clinical Clerk
Ben Paolo C. Rabara
• 55 y/o
• Male
• CC: Shortness of Breath
• Found to have a lung mass, at the left hilum.
Patient was lost to follow up.
• Smoker
• PE: Asymmetrical chest expansion. Decreased
breath sounds, dullness on the Left Lung Field
 Radiographic Findings
• Homogenous opacification of the left lung field
• Cardiac silhouettes missing; Costophrenic sulcus at
the left cannot be appreciated
• Leftward deviation of the mediastinal structures
• Intrusion of the right lung field into the left lung field;
intact hemidiaphragm on the right
• Hyperinflation of the right lung
 Differential Diagnosis
• Complete white-out of a hemithorax
– Pushed away from the opacified side
• Pleural effusion
• Pulmonary Mass
– Remains central in position
• Consolidation
• Pulmonary Edema
– Pulled toward the opacified side
• Pneumonectomy
• Total lung collapse/atelectasis
• Pulmonary agenesis
• Pulmonary hypoplasia
WORKING IMPRESSION
ATELECTASIS
 DISCUSSION
PNEUMONECTOMY
 Pneumonectomy
• This is the complete surgical removal of the
lung.
• Most commonly performed for a primary lung
malignancy.
• The lung is removed in its entirety providing
the patient has adequate pulmonary reserve
from the contralateral lung.
Course of Pneumonectomy
Course of Pneumonectomy
Course of Pneumonectomy
THANK YOU!