CTICasesPneumothorax with Adhesions (in Cystic Fibrosis)
▶ Watch on YouTube — age-restricted, cannot embed here
Imaging findings
Initial chest radiograph showed a very bubbly appearance in the right hemithorax with significant mediastinal shift. CT revealed a multi-septated collection of air in the right hemithorax, where thin adhesions created an appearance mimicking bullae walls. Historical imaging demonstrated progressive bronchiectasis and rarefaction. A post-drainage chest x-ray showed dramatic improvement, confirming the diagnosis of pneumothorax.
Key takeaways
Distinguishing a pneumothorax complicated by adhesions from large bullae is challenging, particularly in patients with cystic lung disease, as adhesions can closely resemble bullae walls. Key differentiating features include a dramatic shift in mediastinal position from prior studies, the appearance of smooth and minimally thickened visceral pleura (rather than gross bullae walls), and a rapid, significant response to chest tube drainage. For non-transplant candidates with recurrent pneumothorax, pleurodesis may be a viable clinical consideration.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Pulmonary AmyloidosisMetabolic
- Hard Metal Pneumoconiosis from Tungsten CarbideExposure
- MALT Lymphoma of the LungNeoplastic
- Crack Cocaine LungExposure
- Undifferentiated Aggressive NeoplasmNeoplastic
- Extramedullary Leukemia (Myeloid Sarcoma/Chloroma) with Thymic and Paraspinal InfiltrationNeoplastic
- Hodgkin's LymphomaNeoplastic
- Intercostal Artery Pseudoaneurysm secondary to Severe ScoliosisVascular
See all cases from April 17, 2015 →