Case 66 Right Lung Oligemia Carcinoid Tumor Of Right Main Stem Bronchus

The CXR shows a hyper-lucent right lung associated with volume loss as indicated by an elevated right hemidiaphragm. CT confirms the presence of the mass in the right main-stem bronchus and the oligemic right lung (Fig. 66.2). Air trapping may be demonstrated on an expiratory CXR showing an exaggeration of the oligemia and the shifting away of the mediastinum. In this patient, bronchoscopy showed a slow-growing carcinoid tumor in the right main-stem bronchus (Fig. 66.3). The differential diagnoses of a hyper-lucent lung are bullae, acute pulmonary embolism, pneumothorax, Macleod's syndrome, and a ball-valve-effect type of bronchial obstruction.

Oligemic Lung Field
Fig. 67.1

Case 67. This patient presented with stridor due to thyroid goiter and was intubated (Fig. 67.1). Repeat CXR was done six hours later (Fig. 67.2). What is the main radiological abnormality? What is the cause?

Right Main Stem

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