Acute Caremiddle twist
A 68-year-old woman is admitted with three days of increasing breathlessness. She has smoked 30 cigarettes a day for 40 years and has lost 6 kg over three months. The left side of the chest is dull to percussion with absent breath sounds. She has never had a chest operation. The chest radiograph shows complete opacification of the left hemithorax, with the trachea and mediastinum drawn to the left, crowding of the left ribs, no air bronchograms and no pleural nodularity. Which one of the following best explains this radiograph?