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Trapped lung — SCE Respiratory MCQ

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HardPleural DiseaseTrapped lungSCE Respiratory

A 70-year-old man with metastatic lung cancer remains breathless after 1.5 L pleural aspiration. Post-procedure radiograph shows a small pneumothorax and the lung has not re-expanded; pleural pressure was very negative during drainage. What is the most likely diagnosis?

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Correct answer: C — Non-expandable trapped lung

Failure of lung re-expansion after fluid drainage with very negative pleural pressures suggests non-expandable or trapped lung. The small post-aspiration pneumothorax reflects pneumothorax ex vacuo rather than tension physiology. Pulmonary oedema and empyema would not explain the pressure-volume behaviour during aspiration.

Reference: BTS Pleural Disease Guideline 2023