Fig 3. Axial slice showing hyperlucency with a very small compressed
right lung and a small left lung.
A ventilation- perfusion scan showed decreased ventilation and perfusion
of the right lung in comparison with the left lung. (Fig 4) The patient
was taken to theatre by the cardiothoracic surgeons who performed a
right postero-lateral thoracotomy and found a large air-filled cyst
arising from the right lower lobe. The cyst had a small neck connecting
it to the right lower lobe. The cyst was excised, and the right lung
lobes immediately re-expanded on ventilation of the right bronchus. A
rigid bronchoscopy performed during the same setting revealed no airway
abnormalities. Post operatively, the patient was ventilated for 2 days
and there were no complications. Histology showed a cyst devoid of
epithelial or inflammatory cells which was consistent with a pseudocyst.
The patient had a good outcome and was discharged home. A month later he
was reviewed, and a repeat chest radiograph was satisfactory. (Fig 5)