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  • Appears to be unilateral pleural effusion on VD view, but is actually fat opacity based on lateral images. There is no silhouette effect with heart or diaphragm.
  • There is moderate bronchial wall thickening at the hilus.
  • Fat opacity in the left hemithorax consistent with intrathoracic lipoma, or possibly diaphragmatic hernia with fat.
  • Bronchial wall thickening/inflammation may have been responsible for the cough
  • This case tested the ability to utilize differential opacities, and was the case that was missed most often in the thorax section this year. This case was failed if pleural effusion was the final diagnosis.