Fig. 6
From: Imaging of urgencies and emergencies in the lung cancer patient
A 64-year-old woman was referred to the pulmonologist for persistent cough and increasing dyspnea. a Erect postero-anterior chest radiograph at the time of presentation shows an enlargement of the left hilum, air trapping in the left hemithorax (suggestive of partial bronchial obstruction) and a left-sided pleural effusion. b Axial contrast-enhanced chest CT in mediastinal window 1 day after the chest radiograph shows a left hilar mass with infracarinal extension, c partially obstructing the left main bronchus (yellow arrow). Although there is only a short time frame between the radiograph and the CT, there is marked volume loss of the left lung and mediastinal shift caused by retro-obstructive atelectasis. Diagnosis of stage IV non-small cell lung cancer was made. Four days after the CT examination, the patient experienced an acute episode of severe dyspnea and stridor for which she was referred to the emergency department. d Erect postero-anterior chest radiograph at admission shows a white lung on the left with massive mediastinal and cardiac shift, caused by complete obstruction of the left main bronchus. No air can be delineated in the left main bronchus. This was confirmed by bronchoscopy