White Out Lung Cancer, Tension Hydro/Hemothorax, and Atelectasis Lung Cancer, Tension Hydro/Hemothorax, and Atelectasis85-year-old female with a history of lung cancer, presents with a dyspnea and hypotension. CXR shows “white out” of the right hemithorax with pressure effect characterised by narrowing of the distal trachea cardio-mediastinal shift and atelectasis in the left lower lobe. The lateral examination shows silhouetting of the right hemidiaphragm.Ashley Davidoff MD TheCommonVein.net106Lu 118469c Lung Cancer, Tension Hydrothorax, and Atelectasis85-year-old female with a history of lung cancer, presents with a dyspnea and hypotension. CT scan shows a large right pleural effusion under pressure, with mediastinal shift to the right. In addition, there is compression of the heart with back up of venous return due the pressure effect on the heart and vascular structures. Among the structures showing venous distension are the SVC (blue arrowhead,a) right sided upper limb veins (blue arrowhead b) and the left upper pulmonary veins (red arrowhead, b. The effusion in the right pleural cavity with atelectatic lung herniates into the left hemithorax, (white arrowhead, c). There is a dense sediment in the pleural fluid (red arrowhead, d) suggesting blood in the pleural cavity. The left atrium is compressed (maroon arrowhead, d)Ashley Davidoff MD TheCommonVein.net106Lu 118467c Lung Cancer, Tension Hydro/Hemothorax, and Atelectasis85-year-old female with a history of lung cancer, presents with a dyspnea and hypotension. CT scan shows a large right pleural effusion under pressure, suggestion of blood in the pleural cavity (orange arrowheads e, f) and mediastinal shift to the right. In addition, there is compression of the heart with back up of venous return due the pressure effect on the heart and vascular structures. Among the structures showing compressive effects are the SVC (blue arrowhead, c) with venous distension on right sided upper limb veins (blue arrowhead a). There is also pressure effect on the trachea with narrowing (light blue arrow d) The effusion in the right pleural cavity with atelectatic lung herniates into the left hemithorax, (white asterisk c, e). There is a dense sediment in the pleural fluid (orange arrowheads, e and f) suggesting blood in the pleural cavity. The left atrium is compressed (red arrowhead, e, f), and the right atrium is compressed (maroon arrow f).Ashley Davidoff MD TheCommonVein.net 106Lu 118450cL Occluded Main Stem Bronchus, Atelectasis of the Right Lung, and Pleural Effusion59F shows total white out caused by collapse of right lung with anoccluded right main step bronchus associated with alarge right sided effusion. The occlusion is likely due to proximal cancer. A pigtail drain has been placed to drain the effusionAshley Davidoff MD TheCommonVein.net 104Lu Occluded Main Stem Bronchus, Atelectasis of the Right Lung, and Pleural Effusion59F shows total collapse of right lung with anoccluded right main step bronchus(top right image)associated with alarge right sided effusion. The occlusion is likely due to proximal cancerAshley Davidoff MD TheCommonVein.net 104Lu Left Lung Collapse and Large Effusion s/p Stent82-year-old female with dyspnea presents with an obstructing lesion of the left main stem bronchus and total atelectasis of the left lung and associated effusion. White out of the left lung with mediastinal shift are noted on the scout film (top left) and the axial images confirm complete collapse of the left lung with a large effusion. A proximal malignancy was found, and the left mainstem bronchus stented, unsuccessfully.Ashley Davidoff MD TheCommonVein.net134720c Left Lung Collapse From a Mucus Plug 68 year old ICU patient has an Xray at 2:30pm to check tube position . 4 hours later he presents with a acute respirtatory difficulty and the re is a white out of the left lung (middle image). After suction, a repeat CXR approximately 2 hours later shows improving aeration. The rapid response to suction usually infers obstruction from a mucus plug or inhalation of a foreign body with removal .Ashley Davidoff MD TheCommonVein.net70231cL White Out After bronchoscopy for Central Cancer 72 year old female with left upper lobe mass s/p bronchoscopy complicated by lung collapse characterised by consolidation, elevated left hemidiaphragm and left ward shift of the cardio- mediastinal shadowAshley Davidoff MD TheCommonVein.net 1 Day After Bronchoscopy Re- Aeration 72 year old female with left upper lobe mass 1 day after bronchoscopy which was complicated by lung collapse (atelectasis). The CXR has returned to baseline with left hilar massAshley Davidoff MD TheCommonVein.net Atelectasis Following Bronchoscopy72 year old female presents with a cough. CT shows a suspicious 3.2cms central, spiculated left upper lobe mass.Ashley Davidoff MD TheCommonVein.net