1. An 82-Year-Old Woman With Left Upper Lobe Atelectasis
Vandana Seeram, MBBS, Adil Shujaat, MBBS, Lisa Jones, MD, Abubakr Bajwa, MBBS, FCCP 
CHEST 
Volume 142, Issue 6, Pages (December 2012)
DOI: /chest
Copyright © 2012 The American College of Chest Physicians Terms and Conditions

2. Figure 1
A, Chest radiograph posteroanterior view demonstrating a Luftsichel sign, which is seen in left upper lobe collapse. This is a paraaortic crescent of air caused by expansion of the superior segment of the left lower lobe due to left upper lobe collapse. It usually extends anywhere from the left apex to the left superior pulmonary vein. B, Chest radiograph lateral view demonstrating an anteriorly displaced major fissure running parallel to the anterior chest wall that is seen as the left upper lobe collapses up against the anterior chest wall. C, CT chest scan revealing left upper lobe atelectasis with diffuse increased density throughout the left upper lobe accompanied by marked anterior displacement of the left major fissure and hyperinflation of the left lower lobe marked by attenuation of the lower lobe vasculature. D, CT chest scan section at the level of the carina suggesting an endobronchial lesion involving the anterior wall of the proximal left main bronchus with complete obstruction of the distal left main-stem/proximal left upper lobe bronchus, with only minimal residual air within the collapsed left upper lobe. Note that the left main fissure is again markedly shifted. Findings are suggestive of endobronchial neoplasia.
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3. Figure 2
Bronchoscopic view of the left main-stem bronchus, with endobronchial lesion in the anterolateral aspect obstructing the left upper lobe bronchus takeoff. The opening to the left lower lobe segments remains patent.
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Copyright © 2012 The American College of Chest Physicians Terms and Conditions

4. Figure 3
A, Clusters of large B cells (hematoxylin and eosin stain; original magnification × 20). B, Tumor cells showing CD20 positivity.
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5. Figure 4
Fused PET-CT scan revealing increased fluorodeoxyglucose uptake involving the left main-stem bronchus with increased soft tissue density tracking along it. Maximal standardized uptake value (SUV) is There is additional hypermetabolic activity in the left hilar region, with an SUV of A, Axial view. B, Coronal view.
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6. Figure 5
Posttreatment CT chest scan at the level of the carina with resolved left upper lobe atelectasis and no endobronchial lesion visible in the left main-stem bronchus.
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Copyright © 2012 The American College of Chest Physicians Terms and Conditions

7. Figure 6
Posttreatment fused PET-CT scan without a metabolically active tumor of the left main-stem bronchus or left hilar region compared with pretreatment imaging.
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