CXR AP and lateral (above) show an opacity in the left upper lobe that was stable over several months. Coronal CT with contrast of the chest (below) shows complete atelectasis of the left upper lobe. There is a soft tissue density present in the lumen of the left mainstem bronchus interrupting the continuity of the left mainstem bronchus. At bronchoscopy this was found to be a very thick mucous plug.
The diagnosis was chronic airway foreign body due to an impacted mucous plug.
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