Frontal (image 1) and lateral (image 2) chest x-ray show a l | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

Frontal (image 1) and lateral (image 2) chest x-ray show a large cystic mass in the right hemithorax causing displacement of the heart, mediastinum, and left lung to the left.

What is the differential diagnosis for this finding? #FridayQuizDay #Quiz #FridayQuiz

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Coronal maximum intensity projection from a chest CT (image 1) demonstrates a pulmonary arteriovenous malformation (arrow), confirmed with pulmonary angiography (images 2 and 3). Pulmonary arteriovenous malformations, which are abnormal connections between the pulmonary artery and vein, create an intrapulmonary right-to-left shunt. They are more common in patients with hereditary hemorrhagic telangiectasia.](https://app.figure1.com/case-detail/165ea2ef-1a51-4eb9-8b26-6747eda83ef2)


this was a RUL ant segment consolidation (pna but f/u to excl tumor bc nodular morphology). CT images are sagital and coronal (images 2&3). Image 4 shows both the Bochdalek hernia and pericardial effusion (v hard to see red/blue arrows). And fig5 shows a normal right hilum. NB the pna shadow projects over r hilum. The hilum itself is normal! Sorry for delay!](https://app.figure1.com/case-detail/42200076-bb5b-455b-8ceb-6078e741cd84)


Coronal SSFSE T2-weighted MR image of the same fetus shows herniation of fluid-containing small bowel loops (black arrow) into the left chest. The meconium-containing colon (white arrow) is dark on T2 sequences but bright on T1 sequences (white arrows on the previous image). The normal right lung (blue arrow) is homogeneously hyperintense in this patient with a large left-sided congenital diaphragmatic hernia. On the previous image, the liver is seen anteriorly with portions above and below the expected level of the diaphragm. Fetal MRI can play an important role in determining prognosis and optimum management in these patients by assessing: 1) the degree of pulmonary hypoplasia, 2) factors associated with pulmonary hypertension, and 3) additional anomalies. #FridayQuizDay](https://app.figure1.com/case-detail/467dcd16-9cc4-4299-95aa-e96304823b0f)


Chest in a newborn with left congenital diaphragmatic hernia shows multiple bubbly lucencies occupying the left hemithorax and displacing the heart and mediastinum towards the right. The stomach and nasogastric tube extend into the left hemithorax. A congenital diaphragmatic hernia is a developmental defect of the diaphragm that allows variable amounts of the abdominal organs to herniate into the chest. Prognosis depends on the amount of pulmonary development. This can be affected by the size and amount of the abdominal content that has herniated into the chest. #ThoraxThursday #ThoracicThursday](https://app.figure1.com/case-detail/7dd85de6-c457-4189-934c-a5d45aefdaf2)