A 4-year-old female with no considerable medical history was admitted for wheezing and shortness of breathing. Symp¬toms had begun about 10 months prior with a continual cough and irregular wheezing. The patient also had irregular fevers up to 103°F. Her primary care provider had evaluated her and prescribed albuterol and dornase alfa (Pulmozyme), which provided some temporary relief; however, symptoms had quickly returned. No chest radio¬graphy was done at that time.
On inspection, the patient was comfortable and in no sensitive distress. Vital signs were as follows: temperature, 100°F; BP, 117/62 mm Hg; heart rate, 110 beats per minute; respiratory rate, 30 breaths per minute. Oxygen dispersion was 91% on 2 L of oxygen delivered by nasal canula. Heart rhythm was normal with no murmurs, rubs, or gallops. Auscultation of the lungs exposed diminished breath sounds on the right with a slight wheeze. The right superior chest was dull to striking. The chest film exposed a large, rounded mass filling most of the right, upper, and mid chest