Left Upper Lobe Mass and Diffuse Reticular-Nodular Infiltrate

Jackson, Harold D.; Carney, K. Jeff; Knautz, Mark A.; Tenholder, Michael F.

doi:10.1378/chest.105.6.1864

Cited by 7 publications

(8 citation statements)

References 9 publications

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“…Occasionally, splenosis occurs in the thorax too and may simulate a mass [49]. There are some diagnostic potential pitfalls in the interpretation of trauma with use of CT, e. g., inhomogeneous contrast enhancement due to scanning too soon after contrast infusion, splenic lobulation, or clefts that may simulate a splenic laceration and motion and streak artifacts simulating a hematoma [38,48].…”

Section: Splenic Injurymentioning

confidence: 99%

Radiology of the spleen

2001

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The spleen is generally not considered a challenge to the radiologist. Most often it poses a problem by anomalies or an irregular but normal contrast enhancement; however, a variety of inflammatory, infectious and neoplastic diseases may involve the spleen. CT and ultrasonography are screening modalities for the spleen. For problem solving, MR imaging can be helpful, especially due to its free choice of the imaging plane and because of the high resolution in contrast MR imaging. Splenic angiography as a diagnostic tool has generally been replaced by CT, ultrasound, or MR and is now used as an interventional method, e. g., in non-surgical management of patients with chronic idiopathic thrombocytopenia or in patients with splenic trauma. This article reviews the radiology of the spleen, including anatomy, embryology, splenomegaly, splenic injury, infarction, cysts, tumors, abscesses, sarcoidosis, and AIDS. Knowledge about the use of different imaging modalities and underlying gross and microscopic pathologic features leads to a better understanding of the radiologic findings.

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Section: Splenic Injurymentioning

confidence: 99%

Radiology of the spleen

2001

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“…Thoracic splenosis was demonstrated with 99m Tc scintigraphy and core biopsy, while adenocarcinoma was diagnosed by transbronchial biopsy. 6,9 Finally, a right lower lobe T 1 N 0 M 0 squamous cell carcinoma was misdiagnosed as a T 1 N 3 M 0 because of ''massive left mediastinal lymphadenopathy''. 11 The supposed left sided lymphadenopathy was discovered to be benign splenosis on further investigation.…”

Section: Discussionmentioning

confidence: 99%

“…2,6,9,11 Investigations must diagnose all lesions suspected of splenosis. When not all lesions can be accounted for, exploration via VATS or thoracotomy is warranted to rule out concurrent malignancy.…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic thoracic splenosis after thoracoabdominal trauma: establishing a diagnosis

et al. 2005

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“…[21][22][23] Although splenosis may be found incidentally at autopsy, numerous case reports document masses as large as 12 cm, which are often confused with tumors and occasionally cause symptoms by invading adjacent tissues and organs. 21,24,25 The location of the implants is limited only by the normal anatomical boundaries, as evidenced by numerous case reports of thoracic splenosis presenting as a mass on the left side of the chest in patients in whom the diaphragm has been disrupted during the splenic trauma. 24 Splenosis has also been reported in the subcutis and the pericardium.…”

Section: Ifferential D Iagnosismentioning

confidence: 99%

“…21,24,25 The location of the implants is limited only by the normal anatomical boundaries, as evidenced by numerous case reports of thoracic splenosis presenting as a mass on the left side of the chest in patients in whom the diaphragm has been disrupted during the splenic trauma. 24 Splenosis has also been reported in the subcutis and the pericardium. 26,27 Splenosis should be distinguished from accessory spleens, which are found in 10 to 40 percent of patients at autopsy.…”

Section: Ifferential D Iagnosismentioning

confidence: 99%

Case 29-1995

Schenkein¹,

Ahmed²

1995

N Engl J Med

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A 65-year-old man was admitted to the hospital because of Hodgkin's disease of the anterior mediastinum and the radiographic finding of a pelvic mass.The patient had been well until about four months earlier, when pleuritic pain developed in the left side of the chest and he entered another hospital. Radiographs of the chest, a ventilation-perfusion scan, and the results of a pulmonary angiographic examination were reported to be normal, and the patient was discharged after three days with a diagnosis of "viral pleurisy." At follow-up examination performed by his personal physician two months later because of left scapular pain, radiographs of the chest (Fig. 1) showed a large anterior mediastinal mass. A computed tomographic (CT) scan of the chest (Fig. 2) revealed a lobulated heterogeneous mass measuring 6 cm in the anterior mediastinum and several enlarged mediastinal lymph nodes. A CT scan of the abdomen (Fig. 3) and pelvis showed evidence of a splenectomy, left nephrectomy, and cholecystectomy. A mass, 4 cm in diameter, abutted the sigmoid colon; another mass, 2.5 cm in diameter, was anterolateral to the descending colon at the level of L1, and a nodule, 1 cm in diameter, was posterior to the descending colon at the level of T12. No retroperitoneal, iliac, or inguinal lymphadenopathy was seen. A CTguided needle-biopsy examination of the anterior mediastinal mass was not diagnostic. Twenty-five days before the admission under discussion, the patient was admitted to this hospital.The patient was a sedentary professional with no known exposure to occupational hazards. He had undergone a splenectomy and left nephrectomy 33 years earlier, after trauma to the abdomen. He first came to this hospital six years before admission because of pneumococcal sepsis, was treated successfully, and re-ceived pneumococcal vaccine. A cholecystectomy was performed elsewhere six months before admission. The patient had been fatigued for eight months and had recently lost an uncertain amount of weight on a low-calorie diet.He did not smoke, drank alcohol sparingly, and took no medications; he reported no fever, chills, sweats, dyspnea, cough, hemoptysis, or bladder or bowel symptoms. Physical examination was negative; no lymphadenopathy or hepatomegaly was found.The hematocrit, white-cell count, and prothrombin and partial-thromboplastin times were normal, as were the values for urea nitrogen,

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Left Upper Lobe Mass and Diffuse Reticular-Nodular Infiltrate

Cited by 7 publications

References 9 publications

Radiology of the spleen

Radiology of the spleen

Asymptomatic thoracic splenosis after thoracoabdominal trauma: establishing a diagnosis

Case 29-1995

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