대한흉부영상의학회 Weekly Chest Cases

Case No : 197 Date 2001-08-06

Courtesy of Tae Jung Kim, M.D., Jin Mo Goo, M.D., Jung-Gi Im, M.D. / Seoul National University Hospital, Seoul, Korea
Age/Sex 69 / M
Chief ComplaintRecurrent hemoptysis for 50 years

Figure 1
Figure 2

Diagnosis With Brief Discussion

Diagnosis: Metallic Foreign Body associated with Chronic Inflammation with Actinomycotic Colony
Radiologic Findings: Chest radiograph shows a dense metallic opacity with an irregular and rectangular margin in the left lower lung zone. Localized consolidation surrounding the metallic density is also observed. Non-contrast CT scan reveals the presence of a metallic foreign body in the posterobasal segment of the left lower lobe with surrounding consolidation and multifocal air cavities.
He was injured by the penetrating trauma due to bomb explosion during the Korean War in 1950s. He complained of recurrent hemoptysis for past 50 years and the incidence and amount of hemoptysis were increased recently. A metallic foreign body was identified during the surgery and the pathologic examination revealed combined actinomycotic colony.
Brief Review: Penetrating wounds of the thorax caused by a gunshot or explosion are rare in Korea; most cases are related to injuries sustained during the Korean War. Complications associated with the presence of metallic foreign bodies in the thorax include atelectasis, obstructive pneumonitis, and pneumothorax or hemothorax. The delayed complication of calcific fibrothorax can occur as a result of previous hemothorax. A foreign body in the pleural cavity may cause chronic empyema, and malignant neoplasm associated with this condition and caused by a metallic foreign body has been reported in the literature.
References: 1. Baharloo F, Veykermans F, Francis R, et al. Tracheobronchial foreign bodies: presentation and management in children and adults. Chest 1999;115:1357-1362.
2. Kim TJ, Goo JM, Moon MW, Im JG, Kim MY. Foreign bodies in the chest: how come they are seen in adults? Korean J Radiol 2001;2:87-96.
Keywords: Lung, Trauma, infection,

No. of Applicants : 23

▶ Correct Answer : 10/23, 43.5%

- 嫄닿뎅
- 怨
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- 諛
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- CHU Nancy-Brabois, France Damien Mandry
- CHU Nancy-Brabois, France Denis Regent
- Ospedale di Fabriano, Italy Giancarlo Passarini
- Stedelijk OLV Ziekenhuis Mechelen, Belgium Ivan Pilate

▶ Semi-Correct Answer : 6/23, 26.1%

- 寃쎈⑥
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- 源
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- Chungnam National University Hospital Sung-Soo Jung

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 197 Date 2001-08-06

Discussion

No. of Applicants : 23