PMC4279718_01
PA chest (a) and lateral neck (b) radiographs obtained day of suspected aluminum tab aspiration fail to demonstrate a metallic foreign body. There is no evidence for supportive findings on chest radiographs such as atelectasis or air-trapping.
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Chest and neck radiographs (Figures 1(a) and 1(b)) did not reveal evidence of an aspirated foreign body, and the patient was told by his physician that he had likely ingested and "passed it."
Reformatted coronal CT MIP image in soft tissue window-level setting (a) demonstrates presence of a hyperdense foreign body (solid arrow) within a thickened left mainstem bronchus (arrowheads). Also noted is subcarinal (block arrow) and hilar adenopathy which was later shown to represent nodal metastasis from lung adenocarcinoma. Axial CT imaging in lung window-level setting (b) shows resultant hyperinflation and hyperlucency of the left upper lobe related to air-trapping.
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Also confirmed was the presence of a metallic foreign body in the left mainstem bronchus (Figure 2(a)). The left lung was hyperinflated and hyperlucent consistent with central airway obstruction and air-trapping (Figure 2(b)).