A 71 year-old man presented for pre-operative assessment prior to a radical neck dissection for squamous cell carcinoma of the tongue. He was an ex-smoker, with known pulmonary fibrosis and bronchiectasis of undetermined aetiology. He denied any respiratory symptoms with no shortness of breath, cough or wheeze. Respiratory examination was notable only for bibasal crackles. Blood work was normal. His mantoux skin test was negative. Imaging evaluation was initially with a chest radiograph, followed by a CT scan of the chest. Both of these examinations are shown in figures 1 and 2 respectively.

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Leinster