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Atelectasis
Atelectasis
Opaque (white)
hemithorax,
caused by non-
aerated lung
Heart shifted to
left
Patterns of Lobar Collapse
• The left lung has 2 lobes (upper, lower), and
the right lung 3 lobes (upper, middle, and
lower)
• The collapse of each lobe has specific
appearances on a CXR
• Examples of each type of lobar collapse now
follow
• A revision of your lung anatomy now might
be helpful
Surface markings of the lobes
The right lung has lost volume and the horizontal fissure is depressed
(red arrow)
Middle Lobe Collapse
Middle Lobe Collapse
The right heart border is blurred. Middle lobe collapse can be very
difficult to detect, and a lateral CXR can be helpful if in doubt (next slide)
Middle Lobe Collapse
Note the wedge shape on the lateral CXR. The horizontal fissure (arrow)
is depressed
Left Upper Lobe Collapse
R
Left Upper Lobe Collapse
Left Upper Lobe Collapse
R
Note loss of left diaphragm contour medially, volume loss of the left hemithorax and
the retrocardiac straight line (representing the collapsed lower lobe)
Take Home Points
• The commonest cause of lobar / total
lung collapse in adults is lung cancer
• All patients with lobar or total lung
collapse need further assessment to
determine the underlying cause
• The CXR appearances of collapse vary
according to where the collapse is