Case 18:
Young kid with an x-ray and MR picture. What is the diagnosis?
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Fig 1 Fig 2
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Study reveals pulmonary aplasia with VSD.



Pulmonary aplasia is complete absence of a whole lung and its bronchus. In lung aplasia there is no lung tissue but a blind main bronchus is present. Both anomalies are characterized by an opaque hemithorax with displacement of the mediastinal structures, diaphragm and contralateral lung from the affected hemithorax. The herniated isolated lung can simulate a hypoplastic lung. The variable volume of the single lung during respiration can also simulate a pleural effusion of the diseased side. It can be easily ruled out when performing an ultrasonography. Due to the left-sided position of the aortic arch and the ductus arteriosus, the left main bronchus may be narrowed in the presence of a right-sided lung agenesis or aplasia, triggering a rotational distorsion of the mediastinum.

Dr. Ashok Raghavan