Unilateral vanishing lung syndrome

A 14-year-old boy was admitted with mild right chest pain, exercise dyspnoea and occasional palpitations. There was no smoking history. There was no past medical history of recurrent chest infections. The physical examination revealed an absence of breath sounds and hyper-resonance of the right hemithorax. A chest X-ray showed unilateral massive bullous disease with radiolucency of right lung and flattening of the right hemidiaphragm (figure 1A). The highresolution chest CT scan confirmed air herniation towards left side with mediastinal shift resulting in airway displacement (figure 1B, C). A significant reduction of right lung perfusion was detected at radioisotope perfusion scan exclusively remaining in the lower lobe (figure 1D). Pulmonary function tests...