Images in Thorax The

pneumonectomy syndrome A 47-year-old woman presented with exertional dyspnoea, cough, nausea and weight loss 2 years after a right pneumo-nectomy for non-small cell lung cancer. CT demonstrated marked mediastinal shift and herniation of the left lung into the pneumonectomy cavity (figure 1A). The left lower lobe bronchus was compressed between the aorta and left pulmonary artery and the oesophagus traversed a tortuous path through the right hemithorax (figure 1B). Respiratory function testing demonstrated gas trapping (residual volume/total lung capacity (RV/TLC) 51%). Surgical intervention to correct the anatomical abnormalities was considered although the patient preferred ongoing conservative management due to perceived risks. Pneumonectomy syndrome is a rare complication occurring after pneumonectomy, which was originally described in 1979.