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By Agustí A., Silvestri G.A., Albert R.K.

An important instrument for all physicians who deal with sufferers with breathing disorder

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Clinical Respiratory Medicine

An important device for all physicians who deal with sufferers with breathing affliction

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Dilatation of the trachea is rare and may result from a generalized defect of connective tissue. Mounier–Kuhn syndrome is the condition that causes the most dramatic tracheal dilatation (Figure 1-67). It is extremely rare and was first described in 1932. On the plain radiograph, shift of the right paratracheal stripe to the right is often the only sign of tracheal widening, and because the trachea is frequently not central, it is only if the left wall of the trachea is also identified that tracheal widening can be recognized.

B, Computed tomography of this mass demonstrates it is of fluid density and was due to a hydatid cyst. (Figure 1-51). A completely or centrally calcified nodule is diagnostic of a tuberculoma or histoplasmoma. Often, CT is required to confirm this pattern of calcification. Likewise, concentric rings of calcification are typical of healed histoplasmosis infection. Popcorn calcification, within the matrix of a pulmonary nodule, is highly suggestive of a hamartoma (Figure 1-52). Other forms of calcification do not reliably indicate whether a nodule is benign or malignant, and dystrophic calcification within a pulmonary malignancy is relatively common.

A bronchial cut-off sign is visible (arrows). A separate pulmonary mass is present in the right upper lobe. FIGURE 1-45 Right middle and upper lobe collapse. Occasionally, this combination mimics left upper lobe and lingular collapse. A, PA view and (B) lateral radiograph demonstrating changes similar to those seen on the opposite side. The major fissure shifts anteriorly and extends from the lung apex to the anterior costophrenic recess. 30 SECTION I Structure and Function right upper lobe collapse also produces appearances that are identical to those of left upper lobe collapse.

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