Phantom tumour of the lung

Abstract

DESCRIPTIONA 55-year-old man with no clinically relevant medical history presented with a 7-day history of right-sided pleuritic chest pain, non-productive cough and night sweats. Physical examination showed no clinical signs of respiratory distress. The laboratory results revealed an elevated C-reactive protein of 5.02 mg/dl and an increased erythrocyte sedimentation rate of 110 mm/h. A posteroanterior chest radiograph showed a phantom tumour as a well-delineated, drop-shaped density in the right middle lung field (figure 1). A CT scan identified multiple mediastinal and right hilar lymphadenopathy, and confirmed a homogenous loculated effusion in the right major fissure, a so-called 'pulmonary pseudotumour'. A tuberculin skin test was strongly positive. A diagnostic thoracentesis showed a lymphocyte-rich exudative pleural effusion with a high level of adenosine deaminase.Tuberculous pleural effusion was diagnosed and a 6-month anti-tuberculosis standard regimen was started.Follow-up examination at the end of treatment revealed resolution of symptoms and radiograph showed complete resolution of the opacity.

Oval-Shaped Radiographic Opacity Mimicking a Lung Mass

“…This may be mistaken for a lung tumor prompting invasive testing such as lung biopsies. However, diuretics can completely resolve these opacities within three days to six months as reported in literature [5] [6] [10]. A repeat imaging after diuresis shows clearing of the radiographic opacity.…”