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Chest clinic
Images in thorax
Interlobar collateral ventilation in severe emphysema
  1. Samih Khauli1,
  2. Servet Bolukbas2,
  3. Robert M Reed3,
  4. Michael Eberlein1,4
  1. 1 Department of Internal Medicine, University of Iowa, Iowa City, Iowa, USA
  2. 2 Department of Thoracic Surgery, Helios University Hospital Wuppertal, University Witten/Herdecke, Wuppertal, Germany
  3. 3 Division of Pulmonary and Critical Care Medicine, University of Maryland, Baltimore, Maryland, USA
  4. 4 Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa, Iowa City, Iowa, USA
  1. Correspondence to Dr Michael Eberlein, Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, C 33 GH, Iowa City, IA 52242, USA; michael-eberlein{at}uiowa.edu

https://doi.org/10.1136/thoraxjnl-2016-208980

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    A 72-year-old female with extensive smoking history and severe emphysema presented with weight loss and failure to thrive. A large right hilar mass was found on a CT of the chest, figure 1A. Despite complete obstruction of the bronchus intermedius, there was full inflation of the right lung, figure 1B, C.

    Figure 1

    CT of the chest. (A) Coronal cut in mediastinal windows showing a large right hilar mass. The mass measured 4.1×4.5 cm and involved the right hilum and subcarinal mediastinum. There was complete encasement and endobronchial obstruction of the bronchus intermedius. (B) Airway segmentation using VIDA|vision software demonstrating the complete endobronchial obstruction of the bronchus intermedius. (C) Three-dimensional segmented airway overlaid on a coronal cut CT of the chest in lung windows. This image demonstrates that, despite the complete obstruction of the bronchus intermedius, there was full inflation of …

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    Footnotes

    • Contributors SK, SB, RMR and ME contributed in the writing and revision of the manuscript.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.