EURORAD ESR

Case 11306

Absence of the left lung: agenesis, aplasia or hypoplasia?

Author(s)
Rafailidis Vasileios, Theodoridis Triandafyllos, Liouliakis Christos, Gavriilidou Anna.

General Hospital of Katerini,
6 km Katerini-Arona
60100, Katerini, Greece;
Vizyis Vyzantos 24
54636 Thessaloniki, Greece;
Email:billraf@hotmail.com
 
Patient
female, 72 year(s)
 
 
  • Figure 1
    Chest radiography

    A radiopaque left hemithorax with shift of the mediastinum to the right is noted. There may be some intestinal loops in the left upper lung zone.

     
    Area of Interest: Lung; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 2
    Double-contrast barium enema

    Displacement of the large intestine into the left hemithorax is noted.

     
    Area of Interest: Abdomen; Anatomy; Cardiac; Imaging Technique: Conventional radiography; Plain radiographic studies; Procedure: Barium enema; Contrast agent-other; Diagnostic procedure; Special Focus: Congenital; Dysplasias; Hernia;
     
     
  • Figure 3
    Axial images of the contrast enhanced CT examination.
     

    Occupation of the left hemithorax by abdominal organ is noted. Namely, mesenteric fat and small intestine in the posterior part of the hemithorax is seen while large intestine is seen in the anterior part.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Congenital;

    The left branch of the pulmonary artery along with the left main bronchus being blind-ended inside the hypoplastic left lung is demonstrated. Small and large intestine are also seen inside the left hemithorax.

     
    Area of Interest: Anatomy; Cardiac; Colon; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Congenital;

    Spleen with its hilum being over the left hemidiaphragm and inside the thoracic cavity is seen.

     
    Area of Interest: Abdomen; Anatomy; Gastrointestinal tract; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Congenital;

    A diaphragmatic defect which allows the abdominal organs to move into the thoracic cavity is revealed. The two separate parts of the left hemidiaphragm are pointed out (orange arrows).

     
    Area of Interest: Abdomen; Anatomy; Colon; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 4
    MultiPlanar Reconstructions and Volume Rendering Techniques of the CT examination.
     

    Coronal reconstructed image shows the left hemithorax occupied by abdominal organs. Namely, the spleen, intestinal loops, the right - displaced mediastinum, the hypoplastic lung (arrow head) and the diaphragmatic...

     
    Area of Interest: Abdomen; Anatomy; Cardiac; Imaging Technique: CT; Procedure: Computer Applications-3D; Diagnostic procedure; Special Focus: Congenital;

    3D Volume Rendering Technique (VRT) shows the normal right lung, the displaced mediastinum and the displaced abdominal organs.

     
    Area of Interest: Abdomen; Anatomy; Cardiac; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Congenital;

    Sagittal view shows the diaphragmatic defect which allows the displacement of abdominal organs.

     
    Area of Interest: Abdomen; Anatomy; Colon; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Congenital;

    Oblique reconstructed image shows the hypoplastic lung in its entity and reveals the existence of both left pulmonary artery (LPA) and left main bronchus (LB).

     
    Area of Interest: Abdomen; Colon; Gastrointestinal tract; Imaging Technique: CT; Procedure: Abscess delineation; Computer Applications-3D; Diagnostic procedure; Special Focus: Congenital;

    VRT image demonstrates the normal aortic arch, the pulmonary artery and the presence of the left pulmonary artery (LPA) which leads to the hypoplastic left lung (LL).

     
    Area of Interest: Anatomy; Arteries / Aorta; Cardiac; Imaging Technique: CT; Procedure: Computer Applications-3D; Computer Applications-Virtual imaging; Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 5
    VRT image showing the lung volume.

    This VRT image shows the right lung having a normal volume. On the contrary, the left lung is seen hypoplastic with the existing left bronchus having some blind-ended branches. Bowel loops are also seen.

     
    Area of Interest: Anatomy; Computer applications; Lung; Imaging Technique: CT; Procedure: Computer Applications-3D; Computer Applications-Virtual imaging; Diagnostic procedure; Special Focus: Congenital;
     
     
A radiopaque left hemithorax with shift of the mediastinum to the right is noted. There may be some intestinal loops in the left upper lung zone.
 
Displacement of the large intestine into the left hemithorax is noted.
 
Occupation of the left hemithorax by abdominal organ is noted. Namely, mesenteric fat and small intestine in the posterior part of the hemithorax is seen while large intestine is seen in the anterior part.
 
The left branch of the pulmonary artery along with the left main bronchus being blind-ended inside the hypoplastic left lung is demonstrated. Small and large intestine are also seen inside the left hemithorax.
 
Spleen with its hilum being over the left hemidiaphragm and inside the thoracic cavity is seen.
 
A diaphragmatic defect which allows the abdominal organs to move into the thoracic cavity is revealed. The two separate parts of the left hemidiaphragm are pointed out (orange arrows).
 
Coronal reconstructed image shows the left hemithorax occupied by abdominal organs. Namely, the spleen, intestinal loops, the right - displaced mediastinum, the hypoplastic lung (arrow head) and the diaphragmatic defect (arrow).
 
3D Volume Rendering Technique (VRT) shows the normal right lung, the displaced mediastinum and the displaced abdominal organs.
 
Sagittal view shows the diaphragmatic defect which allows the displacement of abdominal organs.
 
Oblique reconstructed image shows the hypoplastic lung in its entity and reveals the existence of both left pulmonary artery (LPA) and left main bronchus (LB).
 
VRT image demonstrates the normal aortic arch, the pulmonary artery and the presence of the left pulmonary artery (LPA) which leads to the hypoplastic left lung (LL).
 
This VRT image shows the right lung having a normal volume. On the contrary, the left lung is seen hypoplastic with the existing left bronchus having some blind-ended branches. Bowel loops are also seen.
 
 
 
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