Left upper lobe collapse secondary to lung cancer

Case contributed by Dr George Harisis


Presents from GP with worsening SOB and haemoptysis, 50 pack year smoking history.

Patient Data

Age: 75 years
Gender: Male

Chest X-ray

Veiling opacity in the left hemithorax extending outwards from the hilum and obscuring the left heart border with associated volume loss and elevation of the left hemidiaphragm, consistent with left upper lobe collapse. The right lung and pleural spaces are clear. Flattening of the right hemidaphragm suggests underlying obstructing airways disease. 

A large, central hypodense mass with a dependant locule of gas is obstructing the left upper lobe bronchus and resulting in complete left upper lobe collapse. Associated left loculated pleural effusion. Paraseptal emphysematous changes at the lung apices. 

Case Discussion

Subsequent CT-guided chest biopsy was performed which revealed squamous cell carcinoma. This is a nice example of left upper lobe collapse due to a large obstructing bronchogenic carcinoma (SCC). The aortic knuckle remains visible due to the interposition of the apical segment of the left lower lobe between the collapsed left upper lobe and mediastinum, the so-called Luftsichel sign.

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Case information

rID: 56498
Case created: 5th Nov 2017
Last edited: 15th Mar 2018
Systems: Oncology, Chest
Inclusion in quiz mode: Included

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