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Left lower lobe consolidation

Dr Craig Hacking ◉ ◈ et al.

Left lower lobe consolidation refers to consolidation in part (incomplete) or all (complete) of the left lower lobe.

On this page:

Article:

Pathology
Radiographic features
Differential diagnosis
Related articles
References

Images:

Cases and figures
Imaging differential diagnosis

Pathology

Consolidation refers to the alveolar airspaces being filled with fluid (exudate/transudate/blood), cells (inflammatory), tissue, or other material.

The list of causes of consolidation is broad and includes:

Radiographic features

Consolidation is usually obvious on CT, however features can be subtle on chest radiography. Features of left lower lobe consolidation on CXR include:

opacification of the left upper, mid and/or lower zones
normal (clear and distinct) left superior mediastinal contour (silhouette sign), especially the aortic arch
obscuration of the left hilum, particularly the inferior hilum
obscuration of the descending aortic contour (c.f. left upper lobe consolidation)
normal (clear and distinct) left heart border (c.f. left upper lobe consolidation)
obscuration of the left hemidiaphragm contour (c.f. left upper lobe consolidation)
air bronchograms
on lateral CXR: triangular opacification inferior and posterior to the left oblique fissure and obscuration of the left hemidiaphragm contour

It must be remembered that the homogeneity of the consolidation will be influenced by any underlying lung disease.

Occasionally with complete lobar consolidation, there may be an increased volume of the affected lobe, rather than the more frequent collapse. When the fissures are outwardly convex, the appearance is referred to as the bulging fissure sign.

A mnemonic to remember the general features of consolidation is A2BC3.

Differential diagnosis

left lower lobe collapse will show signs of volume loss

References

Airspace opacification

Article information

rID: 66157

System: Chest

Section: Gamuts

Synonyms or Alternate Spellings:

LLL consolidation
Left lower lobe (LLL) consolidation
Consolidation of the left lower lobe

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Cases and figures

Case 1: LLL consolidationCase 1: LLL consolidation

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Case 1: lateral CXR LLL consolidationCase 1: lateral CXR LLL consolidation

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Case 2: LLL consolidationCase 2: LLL consolidation

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Case 3: LLL retrocardiac consolidationCase 3: LLL retrocardiac consolidation

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Case 4: apical segment LLL consolidationCase 4: apical segment LLL consolidation

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