We report the first case in Korea of a chronic expanding hematoma, which presented as a huge mass in the pleural cavity. A 67-year-old woman exhibiting a slowly-expanding intrathoracic mass, as revealed by a chest radiograph, was admitted to our hospital. The patient had undergone a pneumonectomy 37 years earlier during treatment for pulmonary tuberculosis. Computed tomography revealed a huge mass in her right hemithorax. The differential diagnosis of this mass included chronic empyema combined with a malignancy, such as lymphoma or a soft tissue sarcoma. The tumor, which was classified as an encapsulated chronic hematoma, was removed surgically. Samples sent for histopathological and microbiological analysis revealed no evidence of neoplasia or infection. The patient was finally diagnosed with a chronic expanding hematoma of the thorax. This case is particularly rare due to the patient's development of a very large mass after undergoing treatment for tuberculosis more than 30 years earlier.
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[Show abstract][Hide abstract] ABSTRACT: A 77-year-old man who had undergone mitral valve replacement 5 years previously presented with an intrapericardial mass. Computed tomography and magnetic resonance imaging showed that the mass lesion contained hematoma components. Positron-emission tomography (PET) with 2-[18 F] fluoro-2-deoxy-d-glucose (FDG) revealed uptake in the peripheral rim of the mass. These findings suggested the presence of hematoma associated with a malignant lesion. Surgical resection was performed, and the histological diagnosis was chronic expanding intrapericardial hematoma without neoplastic changes. Chronic expanding intrapericardial hematoma is a rare disease but should be considered when an expanding mass is found in a patient after cardiac surgery. The FDG-PET findings of chronic expanding hematomas, including FDG uptake in the peripheral rim of the mass as a result of inflammation, should be recognized as a potential interpretive pitfall that mimics a malignant tumor.
Journal of Cardiothoracic Surgery 01/2013; 8(1):13. DOI:10.1186/1749-8090-8-13 · 1.03 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Chronic expanding hematoma of the thorax is a specific subtype of the chronic empyema. It presents as a slowly expanding intrathoracic mass which result in dyspnea or recurrent hemoptysis. The symptoms develop months or years after tuberculous pleurisy, trauma or surgery. Usually, it shows three common findings: a giant mass lesion in the thorax, some surrounding calcifications, the absence of signs or symptoms of infection. We report a case of chronic expanding hematoma of the thorax, initially presenting as massive hemoptysis through bronchopleural fistula which resulted in radiologic findings of new air-fluid level within the previous pleural lesion filled with unknown materials. (Tuberc Respir Dis 2008;64:48-51)
Tuberculosis and Respiratory Diseases 01/2008; 64(1). DOI:10.4046/trd.2008.64.1.48
[Show abstract][Hide abstract] ABSTRACT: Chronic expanding hematoma in the chest is identified as a specific type of chronic empyema. We encountered a case of chest chronic expanding hematoma presenting as a huge mass, which compressed the heart, trachea and esophagus. The disease was recognized as a cause of aspiration pneumonia and was successfully treated by surgical resection. Computed tomography revealed a large area of calcifications at the periphery of the mass. Magnetic resonance T2-weighted imaging indicated the mosaic patterns of various signal intensities as specific features of chronic expanding hematoma. Imaging diagnosis showed good correlation with pathology of the disease.
Internal Medicine 02/2008; 47(15):1411-4. DOI:10.2169/internalmedicine.47.0724 · 0.90 Impact Factor