Cystic Bronchiectasis   (b)

This 29 year old Omani man was working as a bus driver.

He presented with chronic cough, hemoptysis and  copious expectoration for more than 10 years.

Radiological and clinical exam revealed massive cystic bronchiectasis of the left lung.
Chest x-ray: P-A view

There was extensive fibrosis with multiple fluid levels.

CT scan chest:
Image1, Image2, Image3, Image4, Image5, Image6

Left pneumonectomy was performed  and postoperative course was uneventful.
Chest x-ray:
        P-A view 2 weeks after surgery
        P-A view 3 months after surgery

Post Pneumonectomy changes:

    The empty space is filled with:
        1- Shifting of mediastinum to the same side.
        2- Elevation of the diaphragm
        3- Crowdness of the ribs, and narrowing of the intercostals spaces
        4- The remaining space will be filled by fluid which is eventually transformed into fibrous tissue.
        N:B nearly after 3 month the field will be homogenously opaque.  P-A view 3 months after surgery
 

Differential diagnosis of unilateral opaque lung field

    1- Massive pleural effusion
    2- Lung fibrosis
    3- clinical pneumonectomy
    4- Lung collapse