ulmonary or not the question is now? Pulmonary manifestation of non-pulmonary diseases

We presents four patients with respiratory symptoms and radiological finding but without pulmonary diagnosis at the end. The first case is mitral chordae rupture, which is understood as a COPD exacerbation due to the dyspnea and fatigue. Considering normal auscultation finding, not smoker, the overall finding did not indicate COPD. Urgent heart ultrasound gave right diagnosis. The second was admitted as bilateral pneumonia. CT scan showed that it was a large intestinal hernia. The third case was presented as pleural effusion after the onset of acute chest pain. Profile radiography and CT scan diagnosed aortic aneurysm dissection and the patient underwent emergency surgery. The fourth patient underwent chest X-ray as part of the preoperative preparation of gallbladder calculosis, where a nodular tumor shadow was seen. CT scan showed that was a pericardial cyst. Imaging findings must be correlated with clinical manifestations. This paper presents some of the faces of non-pulmonary diseases with respiratory manifestations that can lead us a misdiagnosis and sometimes lethal outcome. A multidisciplinary approach, more diagnostic procedures with an adequate history of illness will give us the right diagnosis. In this way, the patient will receive appropriate treatment