An interesting chest radiograph

A 63 year old man presented with a two week history of shortness of breath, fatigue, and cough. He had a 20 pack year ((number of cigarettes smoked each day times number of years smoked)/20) smoking history and no appreciable occupational exposure to dusts such as asbestos or coal. On examination his trachea was slightly deviated to the left with slightly diminished breath sounds over the left lung. Fig 1 Patient’s posteroanterior radiograph (a) and lateral chest radiograph (b) ### Short answers ### Long answers #### Radiological findings The posteroanterior radiograph and lateral chest radiograph show complete collapse of the left upper lobe (fig 1). This is seen on the posteroanterior radiograph as a veil-like increased density projected over the left hemithorax with associated elevation of the left hemidiaphragm and loss of definition of the left side of the mediastinum (fig 1a; arrow).2 On the lateral view the collapsed upper lobe is clearly demarcated from the lucent lower lobe by the …