The objective of this work was to report the tomographic findings in five cases of intrathoracic textilomas. The CT scans of five patients presenting with textilomas after being submitted to thoracotomy for myocardial revascularisation were reviewed retrospectively. Two chest radiologists studied the scans independently, and decisions concerning the CT findings were made by consensus. In each of the five cases, the imaging findings were similar and showed lesions resembling an extrapulmonary mass and well-defined contours situated at the marginal posterior pleural surface. In four of the five cases, a low-density centre and peripheral rim-like enhancement were observed after administration of contrast media. The suspicion of textiloma should be raised when a patient with a history of previous myocardial revascularisation surgery presents with an extrapulmonary mass in close contact with the posterior pleural surface.

OBJECTIVE: The aim of this study was to analyze chest CT scans of patients with thoracic textiloma. METHODS: This was a retrospective study of 16 patients (11 men and 5 women) with surgically confirmed thoracic textiloma. The chest CT scans of those patients were evaluated by two independent observers, and discordant results were resolved by consensus. RESULTS: The majority (62.5%) of the textilomas were caused by previous heart surgery. The most common symptoms were chest pain (in 68.75%) and cough (in 56.25%). In all cases, the main tomographic finding was a mass with regular contours and borders that were well-defined or partially defined. Half of the textilomas occurred in the right hemithorax and half occurred in the left. The majority (56.25%) were located in the lower third of the lung. The diameter of the mass was ≤ 10 cm in 10 cases (62.5%) and > 10 cm in the remaining 6 cases (37.5%). Most (81.25%) of the textilomas were heterogeneous in density, with signs of calcification, gas, radiopaque marker, or sponge-like material. Peripheral expansion of the mass was observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used. Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and pericardial involvement was observed in 2 (12.5%). CONCLUSIONS: It is important to recognize the main tomographic aspects of thoracic textilomas in order to include this possibility in the differential diagnosis of chest pain and cough in patients with a history of heart or thoracic surgery, thus promoting the early identification and treatment of this postoperative complication.

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