PMC7183224_01
(A) Non-contrast CT scan of the chest two weeks after left lower lobe pneumonectomy. A representative image showing absence of a BPF. (B) Non-contrast CT of the chest 6 months after the first chest CT was obtained. Only post-surgical changes in the left lower lung field were noted. No visible BPF noted per the radiology report. (C) Non-contrast CT of the chest 7 months after the first chest CT scan. A notable development of a BPF in the left lower lung field (blue arrow). An air-filled thick-walled cavity in the lower left hemidiaphragm (not shown) was also seen.
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When she re-presented to our hospital one year after her initial diagnosis, CT scan of her chest (Fig. 1A), showed an increasing left lower lobe spiculated lung mass. A CT scan of the chest at that time (Fig. 1B) did not show any developing BPF per the radiology report. Initial work up in the emergency department (ED), including chest x-ray (CXR) and CT scan of the head, showed no evidence of acute disease; however, CT scan of the chest showed interval development of a bronchopleural fistula in the left lower lobe with minimal airspace disease and small amount of pleural fluid (Fig. 1C).