In 1673, the first case of lung agenesis was reported during an autopsy. Since then many more similar cases were reported and a classification of these cases developed for better medical management. Those cases ranged from hypoplasia to aplasia or agenesis of the lung tissue, with a survival rate of less than 50% by the age of 5 years in cases of agenesis. More commonly affecting the left side than the right, here we present a case of a late presentation of right lung agenesis in a young 24-year-old female. Who presented with multiple episodes of shortness of breath over a year. When examined she had an asymmetric chest and dull right sided auscultation. The x-ray done showed a homogeneous opacity in the right upper, middle and lower zone with shift of the mediastinum to the right side, making the heart in dextroposition. Watchfulness need to be maintained when encountering patients with simple complaint, as sometimes, it is not just the normal anatomy.
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