PMC6159281_01
Axial lung window reformat of original diagnostic CT image demonstrating a small soft tissue nodule in the right upper lobe.
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fig1
Contrast-enhanced CT scan of the chest was performed as part of the diagnostic work-up and demonstrated a small 12 mm soft tissue nodule in the right upper lobe (Figure 1).
The first post-operative chest radiograph performed within hours of upper lobectomy. There is increased density adjacent to the right hilum but no lobar parenchymal consolidation. A right central venous catheter, endotracheal tube and right chest drain are also demonstrated. AP, anteroposterior.
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fig2
A chest X-ray performed 24 h after surgery demonstrated significant deterioration in the radiological appearance, with diffuse consolidation in the right upper and mid zones (Figure 2).
Chest radiograph performed 48 h postoperatively. There has been an increase in the right perihilar opacification, with well-defined superior and inferior margins formed by the boundaries of the torted right middle lobe; the diagnosis could have been suspected at this point. Surgical emphysema is seen throughout the soft tissues of the right chest wall. AP, anteroposterior.
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fig3
Over the subsequent 48 h, the radiographic appearances progressively worsened (Figures 3 and 4).
Chest radiograph on post-operative day 3 confirms further deterioration, with more extensive opacification projected over most of the hemithorax but sparing the costophrenic angle and apex. AP, anteroposterior.
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fig4
Over the subsequent 48 h, the radiographic appearances progressively worsened (Figures 3 and 4).