Right middle lobe consolidation

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Right middle lobe consolidation refers to consolidation in part (incomplete) or all (complete) of the right middle lobe.

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 difficult on chest radiography. Features of right middle lobe (RML) consolidation on CXR include:

opacification of the RML abutting the horizontal fissure
indistinct right heart border
loss of the medial aspect of the right hemidiaphragm
air bronchograms
there may also be evidence of some right middle lobe collapse

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 increased in 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

~~-<li><a href="/articles/adult-respiratory-distress-syndrome">adult respiratory distress syndrome (ARDS)</a></li>~~
+<li><a href="/articles/acute-respiratory-distress-syndrome-1">adult respiratory distress syndrome (ARDS)</a></li>
~~-<li><a href="/articles/pulmonary-and-mediastinal-manifestations-of-sarcoidosis">sarcoidosis</a></li>~~
+<li><a href="/articles/sarcoidosis-thoracic-manifestations-2">sarcoidosis</a></li>

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Right middle lobe consolidation

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Pathology

Radiographic features

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