PMC4802684_01
Anterior view of lungs and pericardial sac after removal of the anterior chest wall. Note the tip of superior lobe of left lung protruding over the left contour of the heart (arrow).
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During routine dissection of a 78 year-old male cadaver we found a trapped left lung and enlarged heart almost completely occupying the left pleural cavity (Fig. 1).
Chest radiograph taken during the week before death. Note opacification in left pleural cavity which limits visualization of the heart contours and the trapped lung.
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Multiple chest radiographs taken during that hospital stay (Fig. 2) showed "persistent subtotal opacification of the left hemithorax," and "massive left pleural effusion with minimal aeration of the left lung [and] at least mild cardiomegaly." The subject then underwent thoracentesis to remove the fluid in his left hemithorax, and a repeat radiograph showed "persistent opacification" of the left hemithorax, and noted that "cardiac and mediastinal contours are difficult to evaluate due to adjacent opacification."
Anterior view of the chest after removal of the heart, showing deformed and fibrotic left lung. Note diminutive left lower lobe (arrow).
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The left lung was deformed, and markedly diminished compared with the right lung, particularly in the lower lobe (Fig. 3).
Heart opened to show hypertrophy of ventricular walls and interventricular septum.
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The right ventricular wall, interventricular septum and left ventricular wall measured 240%, 255%, and 326% of values for healthy adults, respectively (Fig. 4), indicating substantial biventricular hypertrophy.