T/c ptb with volume loss s/p ptb treated

T/C PTB WITH VOLUME LOSS S/P PTB TREATED

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Bullous lung disease is characterized by the development of bullae within the lung parenchyma. A bulla is a permanent, air-filled space within the lung parenchyma that is at least 1 cm in size and has a thin or poorly defined wall; it is bordered only by remnants of alveolar septae and/or pleura.

A pulmonary bleb is a small collection of air between the lung and the outer surface of the lung (visceral pleura) usually found in the upper lobe of the lung. When a bleb ruptures the air escapes into the chest cavity causing a pneumothorax (air between the lung and chest cavity) which can result in a collapsed lung.

CT Result:

CLINICAL INFORMATION: Treated PTB. Right lung volume loss. For CT evaluation.

COMPARISON: None

TECHNIQUE: Multislice (16 MDCT) axial sections of the Chest and Mediastinum without contrast with coronal and

sagittal reformation.


There is loss of volume of the right hemithorax and right lung with bronchiectasis, bullae and blebs in the residual aerated

segments of the middle lobe and right lower lobe. There is approximation of the ribs as a result of the volume loss.

There is right pleural thickening.

The left lung is hyperinflated with low set and flattened left hemidiaphragm as well as left retrosternal herniation.

Bronchiectasis seen involving the upper lung apical portion with note of fibrosis and left upper pleural thickening. There

are nodular pleural densities with largest of 1.2 cm. No discrete mass is identified. No pleural effusion is seen.

Heart and mediastinal structures are displaced to the right as a result of right lung volume loss. Heart is not enlarged with

smooth pericardial outline. No pericardial effusion is seen. Aorta is tortuous. No definite hilar or mediastinal

lymphadenopathy.

Ill-defined nodule measuring 1.3 cm with calcification seen in the left thyroid lobe.

The included segments of the liver, pancreas, spleen, upper portion of the kidneys and adrenal glands are unremarkable.

Thoracolumbar spine osteophytes are seen.

IMPRESSION:

  1. Right lung volume loss with bronchiectasis, bullae and blebs in the residual aerated segments of the right lower lobe

with pleural thickening. Findings in keeping with chronic lung disease consider residual from previous tuberculous

disease.

  1. Compensatory hyperinflation of the left lung with left upper lobe bronchiectasis, fibrosis and pleural thickening with

pleural nodules likely part of the post-infection residual.

  1. Atherosclerotic aorta

  2. Left thyroid lobe nodule with calcification

  3. Thoracolumbar spondylosis