PMC4151577_01
(a) Chest X ray at presentation showing right upper lobe homogenous opacity. (b) CT chest showing dense peripheral consolidation of the right upper lobe. (c) Bronchoscopic picture of right upper lobe showing cheesy pseudomembrane lining the right upper lobe bronchial segments.
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fig1
A computed tomography (CT) of the thorax was performed; it revealed dense peripheral consolidation of the right upper lobe with enlarged pre- and paratracheal lymph nodes (Figures 1(a) and 1(b)). As the lesion was deemed not amenable for CT guided biopsy, bronchoscopy was done; it showed mucoid, tenacious, and thick cheese-like pseudomembrane completely lining the right upper lobe bronchial subsegments with a narrow but patent bronchial lumen (Figure 1(c)).
PMC4151577_02
(a), (b), and (c) Chest X ray and CT at presentation showing left lung collapse with mediastinal shift and compensatory hyperinflation of the right lung. (d) Pretreatment chest X ray showing extensive left sided miliary nodules. (e) and (f) Bronchoscopic appearance of pinhole sized left main bronchial opening (arrows).
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fig2
Chest radiogram showed complete collapse of left lung with ipsilateral mediastinal shift (Figure 2(a)). CT of the thorax confirmed the chest radiographic findings (Figures 2(b) and 2(c)). A review of the patient's pretreatment chest X ray showed presence of left sided miliary shadows but no evidence of lung collapse (Figure 2(d)). Bronchoscopy showed complete occlusion of left main bronchus with only a pinhole sized opening (Figures 2(e) and 2(f)).