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)