IF LU 001c Problem Pooja Sikka MD Ashley Davidoff MD Problem CXR – Hyperinflation and LLL infiltrate and Tubular Structures in the Upper Lobes77 year old female with history of asthma, allergic bronchopulmonary aspergillosis (ABPA) and COPDCXR shows hyperinflation, and consolidation in the left lower lobe silhouetting the left hemidiaphragm, with prominent bronchovascular bundles in the upper lung fields seen both on the PA and the lateral Diagnosis: Asthma Allergic Bronchopulmonary Aspergillosis (ABPA) COPDAshley Davidoff TheCommonVein.net Silhouette sign, right middle lobe pneumonia. Initial frontal (A) and lateral (B) radiographs in a patient with clinical suspicion of pneumonia demonstrate obliteration of the right heart border. Follow-up radiographs the next day (C, D) illustrate dense opacification on the lateral view and persisting loss of the right heart border, confirming the presence of a right middle lobe pneumococcal pneumonia.SourceSigns in Thoracic ImagingJournal of Thoracic Imaging 21(1):76-90, March 2006. Solution Next Back to “Image First” Case List Links and References