대한흉부영상의학회 Korean Society of Thoracic Radiology

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Weekly Chest CasesArchive of Old Cases

Case No : 776 Date 2012-09-10

  • Courtesy of Jae-Kwang Lim / Kyungpook National University Hosipital
  • Age/Sex 58 / M
  • Chief ComplaintPalpable mass lesion on the right back area for 1month
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5

Figure 1.

Diagnosis With Brief Discussion

Diagnosis
Scapulothoracic bursitis with intrabursal hemorrhage
Radiologic Findings
Chest CT scan shows well demarcated cystic mass located between the serratus anterior muscle and scapular angle.
MRI reveals a large cystic mass with intracystic hemorrhage at the inferior angle of the right scapula.
Brief Review
Scapulothoracic bursitis is an uncommon disease. It usually appears as a growing mass at the scapulothoracic interface. Histopathologically, it is characterized by the presence of a thickened fibrotic cystic wall with a synovial inner lining and a capillary proliferation. Huang et al (1) have reported sonographic features of a case of scapulothoracic bursitis with pathologic correlation. Higuchi et al (2) have reported 9 cases of painless, distended scapulothoracic bursitis with intrabursal hemorrhage mimicking tumors, and these pseudotumoral lesions regressed spontaneously. Scapulothoracic bursitis may occur alone, or it may associate with some other diseases such as osteochondroma, scapular or rib incongruence, overuse syndrome, rheumatoid arthritis, and systemic sclerosis. On computed tomography (CT) and magnetic resonance imaging (MRI), scapulothoracic bursitis typically is seen as a well-demarcated cystic mass situated between the serratus anterior muscle and the thoracic rib cage along the lateral chest wall.
Conservative treatments such as rest, anti-inflammatory drugs, and intracystic injection of a long-acting corticosteroid, are highly effective in most cases of scapulothoracic bursitis. Surgical resection could be applied for coexistent osseous lesions or when conservative treatment has failed.
References
1. Huang, C.C., Ko, S.F., Ng, S.H., et al. Scapulothoracic bursitis of the chest wall. Sonographic features with pathologic correlation. J Ultrasound Med 2005; 24:1437-1440
2. Higuchi T, Ogose A, Hotta T, et al. Clinical and imaging features of distended scapulothoracic bursitis: spontaneously regressed pseudotumoral lesion. J Comput Assist Tomogr 2004; 28:223
Keywords
chest wall, non-infectious inflammation,

No. of Applicants : 82

▶ Correct Answer : 19/82,  23.2%
  • - SAISEIKAI KURIHASHI HOSPITAL , Japan YASUO OOKUBO
  • - Kyung Hee Universitiy Hospital at Gangdong , Korea (South) Seong Jong Yun
  • - Yokohama-asahi-chuo-general hospital , Japan Kyoko Nagai
  • - Fukuyama city hospital , Japan Ryotaro Kishi
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - izmir hospital , Turkey bakhtiar bakhshi
  • - clinique de SAVOIE , France, Metropolitan gay-depassier philippe
  • - ASAN MEDICAL CENTER , Korea (South) CHONG HYUN SUH
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - Asan medical center , Korea (South) Sang Young Oh
  • - Asan medical center , Korea (South) Hyun Joo Lee
  • - Asan Medical Center , Korea (South) Eunyoung Kim
  • - Asan Medical Center , Korea (South) Hye Jeon Hwang
  • - Hanyang University Hospital , Korea (South) Jina Park
  • - Kizawa Memorial Hospital , Japan Yo Kaneko
  • - Dr.Rajendra Prasad Government Medical College - Tanda, (Himachal Pradesh) , India Narvir Chauhan
  • - Bupyong Serim Hospital , Korea (South) Hee Seok Choi
  • - CAC Rennes , France nicolas gautier
  • - Fukuyama daiichi Hospital , Japan Mototsugu Saeki
▶ Correct Answer as Differential Diagnosis : 3/82,  3.7%
  • - Hanyang University Hospital , Korea (South) Yo Won Choi
  • - IRSA La Rochelle France , France Denis Chabassiere
  • - Saint Malo , France jean-baptiste Noel
▶ Semi-Correct Answer : 24/82,  29.3%
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - SNUH , Korea (South) Euijin Hwang
  • - SCGH , Australia Yuranga Weerakkody
  • - royal melbourne hospital , Australia kimchi kings
  • - UWO , Canada S Lee
  • - Chonnam National University Hospital , Korea (South) Jung hyun Kim
  • - HIA Legouest - METZ , France Alban Gervaise
  • - jaslok hospital & research centre mumbai , India JAINENDRA JAIN
  • - Samsung Medical Center , Korea (South) Chae Jin Jeong
  • - Korea university , Korea (South) Kun Woo Kang
  • - McGill university , Canada Badriya Al-qassabi
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Ishikawa Matto Central Hospital , Japan Manabu Akimoto
  • - James Paget Hospital , U.K , United Kingdom nabil mahmood
  • - Radnet Teleradiology Istanbul , Turkey Armagan Sarac
  • - Scans world , India Philson Mukkada
  • - Chungbuk University Hospital , Korea (South) Yunhee Jang
  • - Chungbuk univertisy hospital , Korea (South) Soohyun Lee
  • - chungbuk national university hospital , Korea (South) soojung lee
  • - Ondokuz Mayis University , Turkey Cetin Celenk
  • - Kohka Public Hospital , Japan Akitoshi Inoue
  • - All India Institute of medical sciences , India Justin Moses
  • - Mallinckrodt Institute of Radiology , United States Naganathan Mani
  • - IRSA , France, Metropolitan BIGOT
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