Weekly Chest CasesArchive of Old Cases

Case No : 38 Date 1998-07-20

  • Courtesy of Jeung Sook Kim, M.D., Joon Hyuk Choi, M.D. / Pochon CHA University, Pundang CHA General Hospital
  • Age/Sex 56 / M
  • Chief Complaintknown lung mass, no specific complaint
  • Figure 1
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  • Figure 3
  • Figure 4

Chest PA

Diagnosis With Brief Discussion

Diagnosis
Round atelectasis
Radiologic Findings
Brief Review
Round atelectasis is a form of chronic atelectasis resembles a mass, which can be confused with bronchial cancer and frequently associated with asbestosis. Mechanism is uncertain, and one suggestion is that passive atelectasis on adjacent lung by pleural exudate which occur in such disease as asbestosis, tuberculosis, other infections, therapeutic pneumothorax, uremic pleuritis, or pulmonary infarction. Other mechanism is that a sheet of maturing pleural fibrosis cause atelectasis underlying lung.
Major feature on CT scan is peripherally located opacity based against pleura with thickened pleura both over the lesion and other part of pleural cavity. The lesion may be single or multiple, most commonly in posterior lower lobe, usually oval shaped and angled with pleural surface. It causes distortion and displacement of blood vessel and bronchi pulled toward the lesion causing characteristic curvilinear configuration referred as ‘Comet tail sign’. Margin of the lesion shows usually sharp border with blurred border adjacent hilum by entering blood vessel. Air-bronchogram and calcification is sometimes present. Enhancement pattern is like lung cancer or other pathologic condition, so, of little diagnostic value. This lesion is usually static but it may grow, shrink, or even resolve spontaneously. The CT finding may be definitive, so no further study to exclude malignancy presented as mass is necessary.
References
Keywords
Lung, Pleura, atelectasis,

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