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the chest x-ray on the right is normal the x-ray on the left-hand side is an excellent teaching case it shows parenchymal and architectural changes in a patient with the history of pulmonary tuberculosis 27 years ago the first thing you should notice the loss of lung volumes bilaterally the lungs look smaller both kyla are displaced upward mediastinal contours are very different from what they should normally be blood vessels appear to be stretched and are being pulled up very obvious fibrous cars and Bullis changes are in both upper zones Ebola is a permanent air filled space within the lung parenchyma which is at least one centimeter or bigger in size and has a thin or poorly defined wall it is bounded by remnants of alveolar septa and/or pleura you can see an irregular and a somewhat beaded shaped trachea there is a tracheal deviation towards the right side healed parenchyma in both upper zones is shrunken which has resulted in distorted architecture of the lungs cardio fran