35 Cicatrization Atelectasis

Clinical Presentation

51-year-old man who is now five months status post mantle radiation therapy for unresectable adenocarcinoma of the lung

Radiologic Findings

PA (Fig. 35.1A) and lateral (Fig. 35.1B) chest radiographs demonstrate well-defined opacities with sharp borders involving the superior mediastinum and paramediastinal lung zones. The bronchi within the affected lung are distorted and dilated. Note the hilar retraction, diaphragmatic elevation, and compensatory overinflation of the uninvolved lower lungs. Chest CT (lung window) (Fig. 35.1C) reveals sharply demarcated bands of increased attenuation in the medial anterior and posterior paramediastinal lung zones. Note the traction bronchiectasis and bronchovascular reorientation in the affected lung.