Pneumonectomy. This 65 year old woman had a right pneumonectomy for lung cancer. Multiple surgical clips are present at the right hilum. Note the complete opacification (‘white-out’) of the right hemithorax, caused by fluid filling the remaining space where the lung used to be. There is evidence of volume loss, as the trachea has shifted to the right (note how it no longer lies in front of the spinous processes). If we could see the right heart border, we would be able to tell that it has also shifted to the right, and if we could see the right hemidiaphragm, we would know that it had shifted upwards – but there is no longer any air in the right hemithorax to give us a ‘silhouette’ of the heart border or right hemidiaphragm, so we have to assume this to be the case.