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Emphysema on chest x-ray

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Dyspnea, fevers.

Patient Data

Age: 65
Gender: Female
x-ray

The lungs are hyperexpanded with coarse bronchovascular markings in keeping with COPD. There is increased AP diameter and increased retrosternal airspace but the diaphragms have a near normal contour. 

ct

CT confirms a predominantly centrilobular emphysematous pattern and over-inflation of the lungs. 

Case Discussion

This case is a nice example of emphysema on chest x-ray without overtly flattened hemidiaphragms but quite increased retrosternal airspace that contributes to lung hyperexpansion. 

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