CTICasesLoculated Postoperative Fluid Mimicking Left Upper Lobe Collapse (Luftsichel Sign Mimic)
Imaging findings
Postoperative chest radiographs show an apparent left upper lobe atelectasis with a classic Luftsichel sign (hyperinflated superior segment of the left lower lobe abutting the aortic arch). CT reveals this is actually a loculated postoperative fluid collection in the anterior post-lobectomy space mimicking collapse in a patient who had already undergone a left upper lobectomy.
Key takeaways
Loculated postoperative fluid or air in a post-lobectomy space can perfectly mimic the radiographic appearance of lobar collapse, including the classic Luftsichel sign. Cross-sectional imaging and correlation with the patient's surgical history are essential to avoid misdiagnosing a post-lobectomy fluid collection as acute bronchial obstruction or atelectasis.
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