Fig 1- X rays of the Chest taken in AP view in supine position before and after placement of right sided intercostal drainage tube (ICD).
Both X rays show multiple thin walled, rounded, air filled cystic lesions in both lungs (yellow arrows), s/o Pneumatoceles. A well defined soft tissue density lesion is seen projecting into the cavity in right lower lung from its medial wall (red arrows).
In Fig 1A (Pre ICD insertion)- Surrounding the pneumatoceles is an area of relative lucency, which appears to be completely devoid of lung markings (black arrow). Opacity is seen along the right lateral chest wall and in the region of right costo-phrenic angle (white arrow). These findings are s/o presence of both fluid and air in the pleural cavity in the Chest X ray of the patient taken in the supine position.
Fig 1B (Post ICD insertion)- There is marked reduction in the amount of air in right pleural cavity, while no change is appreciated in the appearance of pneumatoceles or the intracavitary soft tissue mass.