Assessment #1 case #10

Diffuse hazy pacification of the L hemithorax concerning for layering pleural fluid. No focal airspace consolidation. The R lung is clear.

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left upper

opacification of the L hemithorax, which may be due to layering left pleural effusion

Abnormal bulging contour of the left paraspinous line which may represent thoracic aortic aneurysm/abnormality. Consider further evaluation with CT. Increased density of the left lung which may represent layering left pleural effusion or atelectasis.

Large left pleural effusion.

Ptx

left apical tension pneumo with mediastinal shift .

Large left presumably hemothorax with collapsed left lung. Several acute left rib fractures. Leftward mediastinal shift.

FINDINGS/IMPRESSION:

Hyperexpanded lungs bilaterally. No pneumothorax. Possible small left pleural effusion. There is a left perihilar opacity. The left lung also appears diffusely hazy compared to the right lung. The bilateral diaphragms have an irregular contour.

There is marked calcific atherosclerosis of the thoracic aorta. Multilevel degenerative changes of the thoracic spine. Degenerative changes at the shoulders as well. The heart size is normal.

IMPRESSION:

1. Indeterminate left perihilar opacity. Recommend chest CT for further evaluation.
2. Hyperexpanded lungs, likely COPD.

Left upper lobe pneumonia.

layering pleural effusion.no focal dz
vascular calcifications

Evidence of massive edema of the entire left lung field.

Asymmetric opacification of the left lung compared to the right with slight hyperexpansion of the right compared to the left. Trachea remains midline. Rounded density projects over the left mediastinum. Bilateral pleural effusions, small. Obscuration of the left cardiac border. On lateral view, left lower lobe appears more lucent compared to the rest of the lung. Potentially this could represent obstruction of the left upper lobe bronchus by a mediastinal mass with atelectasis of the LUL? (help me)

Recommend CT of the chest for further evaluation.

Complete opacification of the left lung with left pleural effusion. Retrocardiac opacity; query pneumonia. Atherosclerotic aortic knob.

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Left hilar mass?
Diffuse opacification of the left lung

A large air-filled structure occupying the entire left hemithorax, likely representing a very large hiatal hernia.

Left upper lobe pneumonia.
Small BIL pleural effusions.

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Large left pleural effusion.

Cardiomediastinal silhouute is unremarkable.

Bones and soft tissues are unremarkable.

LEFT atelectasis secondary to lobar collapse

LUL pna

lul atelectasis

White out of left hemithorax on AP view, corresponding to complete atelectasis of left upper lobe on lateral view. Pneumonia is a consideration. Obtain follow-up radiographs or CT to assess for obstructive pathology.

Left upper lobe collapse with deviation of the mediastinum to the left. The left lower lobe remains expanded. The right lung is normal. No pneumothorax or pleural effusion. No focal consolidation.

The heart size is normal. No osseous abnormality.

Left upper and lower lobe atelectasis with mildly elevated left hemidiaphragm.
Right lung is clear and well aerated.
No acute bony abnormalities

LUL collapse

Left upper lobe collapse with deviation of the mediastinum to the left. The left lower lobe remains expanded. The right lung is normal. No pneumothorax or pleural effusion. No focal consolidation.

The heart size is normal. No osseous abnormality.

Left hilar mass with left upper lobe collapse.

Left hilar mass with upper lobe collapse and pleural effusion

Left upper lobar atelectasis

White out of the left lung with deviation of the mediastinum to the left, with possible cutoff of the left mainstem bronchus concerning for mucus pulg, which could be evaluated with bronchoscopy.
No discernable pneumothorax or pleural effusion.

Left upper lobe collapse.

Left upper lobe collapse.

Left upper lobe collapse with opacification of the left hemithorax. Findings concerning for central left bronchus obstructing mass. Recommend CT chest for further evaluation.

Uniform slight opacification of the left hemithorax, with an abrupt cut off of bronchus, favored to represent left upper lobe collapse, likely secondary to mucous plugging.

Small layering left pleural effusion.

Tortious contour of the thoracic aorta which could be concerning for aneurysm or dissection, consider CTA Chest for further evaluation if clinically indicated.

Complete hazy opacification of the left hemithorax with leftward tracheal and mediastinal deviation. Abrupt cutoff of the left mainstem bronchus. Findings are concerning for lobar collapse with mucus plugging. Right lung is well aerated without focal consolidation. No right sided pleural effusion.

Lucencies about the aortic arch and superior mediastinum concerning for pneumomediastinum.
Left mediastinal mass and diffuse opacification of the left upper lobe.
Sm left pleural effusion.
Vascular calcs.

Rec CT for further eval.

Diffuse opacification of the left hemithorax with evidence of volume loss concerning for complete collapse of the left lung. Possible component of layering pleural effusion.

Complete opacification of the right lung field.

Left upper lobe collapse, which may be due to an obstructive mass. Consider CT for further evaluation.

Right lung is well aerated.

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LUL collapse

Left upper lobar atelectasis

Left hemithorax white-out due to large pneumothorax of the left lung (complete lobar collapse) with leftward tracheal deviation. Recommend surgical consultation. Hyperinflated right lung. Small left pleural effusion. Tortuous thoracic aorta. Normal cardiopulmonary silhouette. No acute osseous abnormality.

Lul collapse
Leftward trachea

Atlectasis of the left upper lobe, possibly secondary to mucous plugging. Small bilateral pleural effusions. Background of emphysematous chagnes.

Near-complete opacification of the left lung with elevation of the left hemidiaphragm and obscuration of the left heart border. Findings are consistent with left upper lobe collapse. Recommend repeat imaging to resolution to rule out underlying mass.

Otherwise, bilateral hyperinflation and coarse interstitial markings as can be seen in the setting of chronic obstructive lung disease.

Aortic atherosclerosis.

Veil like opacification of the left lung, leftward mediastinal shift, and lucency around the inferior aorta consistent with left upper lobe collapse. Although this may be due to mucus plugging, underlying hilar mass is a possibility. Recommend CT chest for further evaluation.

Large left hydropneumothorax with partial lobe collapse and left sided mediastinal shift.

LUL collapse

Left upper lobe atelectasis / collapse and associated mild right to left mediastinal shift.

Left upper lobar collapse with hyperinflation of the left lower lobe and luftsichel sign, which can be seen with obstructing neoplasm. Recommend CT chest with contrast for further evaluation.

Findings concerning for LUL collapse. Recommend CT to evaluate for mass lesion.

Thoracic descending AA
LUL collapse

Acute left upper lobe collapse. Luftsichel sign. Leftward tracheal deviation. Although a hilar mass is not definitely visualized, the collapse raises concern for an obstructing lesion and CT chest is recommended.

left lung collapse.

luftsichel sign.
Complete opacification of left lung and leftward mediastinal shift suggestive of collapse secondary to main bronchus obstruction

Complete opacification of the left hemithorax. Large left pleural effusion. possible left upper lobe collapse. obscuration of the left cardiomediastinal silhouette.

right sided pneumothorax

Left upper lobe collapse.

Left upper lobe collapse.

Veiling opacity projecting over the left chest with the luftsickel sign concerning for left upper lobe collapse. In at outpatient setting, an obstructing mass needs to be ruled out.

Tension pneumothorax.
Right to left shift of the mediastinum.

Left upper lobe and lingular atelectasis with Luftsichel sign involving hyperinflation of the left lower lobe. This can be seen with an obstructive bronchial mass. Consider CT chest with contrast for further evaluation.

Increased opacification of the left lung with luftischel sign, juxtaphrenic peaking of the left hemidiaphragm and superior displacement of left major fissure on lateral view concerning for left upper lobe collapse. Recommend Chest CT for evaluation of obstructing mass.

Hazy opacities symemtrically throughout the left lung on frontal w/ partial LUL collapse and hyperinflation of the LLL on lateral x-ray.

This may represent collapse secondary to mucus plugging vs obstructive mass which is not well-characterized. Recommend bronch for further eval.

Hazy opacification of the left hemithorax which is concerning for left upper lobe collapse which may be secondary to an obstructing mass lesion. Recommend CT for further characterization.

Opacification of the left upper lobe with associated leftward deviation of the trachea concerning for LUL collapse. Consider bronchoscopic evaluation.

AP and lateral views of the chest are provided.

The mediastinum is shifted to the left. The trachea is mildly deviated to the left.
There is complete mild opacification of the left lung relative to the right on the AP view. With the opacification being anterior on the lateral view. The right lung is normal. No focal consolidation.

No large pleural effusion or pneumothoraces are present.

No acute osseous or soft tissue abnormality is present. Spondylosis is present.

Impression:
Left upper lobe collapse/atelectasis.

There is a deep sulcus sign at the right medial lung base. There is leftward shifting of the mediastinum. There is complete whiteout of the left lung field. These findings are suggestive of a tension pneumothorax.

Pneumomediastinum with complete opacification of the left lung

LUL atalectasis

LUL collapse, rec CT to rule out obstructing mass

left upper lobe collapse with presence of left hilar mass. Suspicious for malignancy recommend CT for further evaluation.

Complete collapse of the left upper lobe, with scimitar sign. These findings raise concern for a possible central hilar mass causing obstruction. This may be further evaluated with CT.

Near complete opacification of the left upper lobe without displacement of the major fissure. Obscuration of the left heart border. Abnormal density in the left hilum. Elevated left hemidiaphragm.

opacification of left hemilung with left perihilar fullness concerning for perihilar mass

l lobar collapse, hiilar mass

total LLL collapse with left sided mass

opacification of the left upper lobe with prominence of the left hilum, concerning for obstructive left hilar mass. recommend CT for further evaluation
no pleural effusion or pneumothorax
aortic atherosclerosis

Increased opacity of L hemithorax, c/f LUL collapse

There is a left perihilar mass as well as opacification of the left lung representing left upper lobe collapse, likely secondary to the mass. No sizeable pleural effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute bony abnormality.

Acute hazy opacification of the Left upper lobe concerning for lobar collapse. In the AP view, there is a small rounded opacity along the left hilum, concerning for mass which may be occluding the left upper mainstem bronhcus.

Left basilar opacities consistent with atelectasis

no pleural effusions

Consider CT for further eval.

Collapse of the LUL. Increased soft tissue density in the region of the left hilum which is concerning for obstructing mass. CT w/ contrast could further evaluate.

_ x _ cm left hilar mass lesion, with associated post-obstructive complete collapse of the left upper lobe. This results in mild leftward mediastinal shift and tracheal deviation. Recommend CT chest for further evaluation.

Mild interstitial coarsening in the bilateral lung bases with small bilateral pleural effusions, possibly relating to volume overload versus pulmonary hypertension related to mediastinal pathology, which can also be evaluated with CT imaging.

No pneumothorax. No acute extrathoracic findings.

Veil-like opacity of the left lung likely secondary to partial collapse of the left upper lobe. Soft tissue density in the left hilum is concerning for a mass. CT chest could further evaluate.

L opacification

Consolidation of the left lung

Left upper lobe collapse. Prominence of the left hilum which may represent an obstructing mass, recommend dedicated CT chest wo contrast for further evaluation.
Bilateral costophrenic angle blunting which could be secondary to trace bilateral pleural effusions vs chronic scarring. No overt edema.

Already typed and wasnt saved.

-Left upper lobe hazy opacification concerning for lobar collapse. Difficult to exclude superimposed infection in the correct clinical setting.
-Prominence of the left lung hila, recommend interval imaging upon resolution of the collapse for better evaluation.
-If there is continued collapse of repeated infection, this could be post-obstructive in nature and could be further evaluated with CT if there is clinical suspicion.

Left upper loba elobar collaps with pissible mucous plug

Opacification of the Left lung with leftwards mediastinal shift concerning for left upper lung atelectasis/collapse. There is an opacification in the left hilar region that could be vascular crowding due to lung collapse vs mass. Recommend further evaluation with CT chest once clinically possible.
Left sided pleural effusion. Linear opacification in the right lung base, favored atelectasis.
Aortic calcifications.
No acute osseous abnormalities.

LUL collapse with a prominent l hilum/abnormal contour of the AP window is suggestive of an obstrcting mass. rec ct for further eval.

small b/l pleur eff

Opacification/partial collapse of the left upper lobe. Density at the left hilum raises concern for possible underlying mass, recommend CT for further evaluation.

Left upper lobe collapse with slight leftward mediastinal deviation. Rounded left hilar opacity may represent obstructing mass. Questionable trace bilateral pleural effusions. No pneumothorax. Aortic calcifications.

LUL opacification, likely lobar collapse.

Left upper lobe collapse which may be secondary to left perihilar mass. Recommend chest CT with contrast.

LUL atelectasis, likely L perihilar mass and luftsichel sign?

Minimal aeration of the left lung with masslike opacity left lateral to the descending aorta, consistent with hilar overlay sign. Query mediastinal mass.

No mediastinal shift. Scattered atelectasis.

mass

Opacification of the left hemithorax with obscuration of the left heart border. Small left pleural effusion. No pneumothorax. Mild leftward mediastinal shift and asymmetric elevation of the left hemidiaphragm suggest consolidation/collapse. Left hilar mass vs enlarged LPA. If mass, could represent postobstructive LUL collapse. CT could further assess.

Diffuse opacification of the left lung with left perihilar soft tissue density, concerning for an obstructing mass.

Asymmetric opacification of the left hemithorax with luftschiel sign suggestive left upper lobe collapse secondary to left hilar mass. Recommend CT for further eval.
Mild blunting of the left CP angle, query trace left pleural effusion.