CXR AP (left) shows bilaterally hyperexpanded lungs with multiple circular bubbly and branching interstitial lucencies bilaterally which appear to radiate from the hila. CXR AP obtained 1 day later (right) shows a large amount of air in the left pleural space causing mediastinal shift to the right and depression of the left hemidiaphragm resulting in a left-sided deep-sulcus sign.
