Transthoracic echocardiography showing pulmonary arteries and arch of aorta

Clinical introduction

An 18-year-old male patient with a history of Hodgkins lymphoma came to emergency department with complaint of breathlessness. His respiratory rate was 26/min, room air saturation was 98%, heart rate 120. On examination, his trachea was shifted towards right side and there was decreased air entry on right lung. Chest X-ray (figure 1) and point of care ultrasound were performed (figure 2).

Figure 1

Chest xray PA view.

Figure 2

Echo by point of care ultrasound

Question

What is the tubular structure seen in the ultrasound image?

Septate pleural effusion

Lung cavitation

Arch of aorta

Lung abscess

Answer C: Arch of aorta

The X-ray shows complete opacity of the right lung, suggesting it …