60 yo F with shortness of breath

Original case by Brandon Fainstad, MD. Edits by Yilin Zhang, MD. 


CASE:

A 60 year old woman with mucinous NSCLC and a chronic pleural effusion presents with slowly progressive SOB.

How would you interpret this CXR?


CASE CONTINUED:

A right sided VATS was performed the next day with lysis of fibrous pleural adhesions in an attempt to free up the lung.  Unfortunately, the lower and middle lobes could not be expanded so a talc pleuradesis was not attempted.  Instead a PleurX catheter was placed for frequent drainage.

How would you interpret this CXR?


What is trapped lung? 

How can it be differentiated from a pneumothorax caused by a thoracentesis?