Thursday, September 19, 2013

Case review 2: Right Lower Lobe Collapse


History

A 31 year old lady presented to her GP (Klinik Chung) with a 1 month history of chronic cough. A chest radiograph was done.

X-ray findings

The x-ray showed a homogenous triangular opacity at the right lower zone with well-defined upper border.
The right heart border can be seen through the shadow but the right hemi-diaphragm and costo-phrenic angle are obliterated.
The findings are consistent with a right lower lobe collapse.


Other features to look for are elevated hemi-diaphragm and depressed right hilum. The radiologic features are summarised in this diagram: 

The causes for this kind of lung collapse may be divided into: 
  1. Luminal: causes include aspirated foreign material or mucous plugging. 
  2. Mural: cause is usually due to bronchogenic carcinoma. 
  3. Extrinsic: cause may be due to compression by adjacent mass.
Further management

The next course of action would be to do bronchoscopy. 


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