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He presented with dyspnoea due to exposure to grill smoke in his job as a kitchen assistant. Dyspnoea improved after 6 months off work, with persistent dyspnoea on exertion. Spirometry showed the following values: FVC: 4.09 (90%), FEV1: 2.70 (79%) and FEV1%: 66%. The bronchodilator test was positive, suggesting bronchial hyperresponsiveness. Inspiratory chest CT scan showed a left apical calcified millimetric lung nodule and left hilar calcified lymphadenopathy, probably related to a history of tuberculosis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B, white arrows), areas of right apical paraseptal pulmonary emphysema (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C, white arrows) and diffuse bronchial thickening (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>D, white circles). The mediastinum was displaced towards the right hemithorax and areas of air trapping were visible in the expiratory study (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>, white arrows). The patient was diagnosed with bronchial asthma and treatment with corticosteroids and bronchodilators was decided.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The pendular motion of the mediastinum consists of a deviation of the mediastinum towards one hemithorax during the respiratory cycle, so CT in inspiration and expiration will allow us to assess it. It is caused by any condition that creates different pressures between the two hemithoraces, such as endobronchial stenosis, pulmonary parenchymal disease or small airway obstruction.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1168 "Ancho" => 1667 "Tamanyo" => 235150 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 555 "Ancho" => 1667 "Tamanyo" => 193638 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000016000000012/v1_202306191131/S2387020623002061/v1_202306191131/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000016000000012/v1_202306191131/S2387020623002061/v1_202306191131/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623002061?idApp=UINPBA00004N" ]
