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Thoracic textilomas: CT findings.

Machado DM, Zanetti G, Araujo Neto CA, Nobre LF, Meirelles GS, Silva JL, Guimarães MD, Escuissato DL, Souza Jr AS, Hochhegger B, Marchiori E - J Bras Pneumol (2014)

Bottom Line: Peripheral expansion of the mass was observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used.Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and pericardial involvement was observed in 2 (12.5%).It is important to recognize the main tomographic aspects of thoracic textilomas in order to include this possibility in the differential diagnosis of chest pain and cough in patients with a history of heart or thoracic surgery, thus promoting the early identification and treatment of this postoperative complication.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Antonio Pedro University Hospital, Fluminense Federal University, Niterói, Brazil.

ABSTRACT

Objective: The aim of this study was to analyze chest CT scans of patients with thoracic textiloma.

Methods: This was a retrospective study of 16 patients (11 men and 5 women) with surgically confirmed thoracic textiloma. The chest CT scans of those patients were evaluated by two independent observers, and discordant results were resolved by consensus.

Results: The majority (62.5%) of the textilomas were caused by previous heart surgery. The most common symptoms were chest pain (in 68.75%) and cough (in 56.25%). In all cases, the main tomographic finding was a mass with regular contours and borders that were well-defined or partially defined. Half of the textilomas occurred in the right hemithorax and half occurred in the left. The majority (56.25%) were located in the lower third of the lung. The diameter of the mass was ≤ 10 cm in 10 cases (62.5%) and > 10 cm in the remaining 6 cases (37.5%). Most (81.25%) of the textilomas were heterogeneous in density, with signs of calcification, gas, radiopaque marker, or sponge-like material. Peripheral expansion of the mass was observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used. Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and pericardial involvement was observed in 2 (12.5%).

Conclusions: It is important to recognize the main tomographic aspects of thoracic textilomas in order to include this possibility in the differential diagnosis of chest pain and cough in patients with a history of heart or thoracic surgery, thus promoting the early identification and treatment of this postoperative complication.

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Related in: MedlinePlus

Intravenous contrast-enhanced chest CT scan with mediastinal windowsettings. Presence of a bulky cystic mass (arrows) with regular contours andwell-defined borders, occupying and bulging the entire lower third of theright hemithorax and crossing the midline. Note peripheral contrastenhancement and typical folds (arrowheads) within the cystic mass,corresponding to the retained surgical sponge.
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f01: Intravenous contrast-enhanced chest CT scan with mediastinal windowsettings. Presence of a bulky cystic mass (arrows) with regular contours andwell-defined borders, occupying and bulging the entire lower third of theright hemithorax and crossing the midline. Note peripheral contrastenhancement and typical folds (arrowheads) within the cystic mass,corresponding to the retained surgical sponge.

Mentions: All cases presented as a (round or ovoid) mass with regular contours and borders thatwere well-defined or partially defined. In 7 cases (43.76%), the mass measured nomore than 5 cm in diameter; in 4 (25.00%), it measured 10-15 cm; in 3 (18.75%), itmeasured 5-10 cm; in 1 (6.25%), it measured 15-20 cm; and in 1 (6.25%), it measured20-25 cm. Three (18.75%) of the 16 masses were homogeneous, and 13 (81.2%) wereheterogeneous. It was possible to identify images consistent with sponge-likematerial in 6 (46.1%; Figure 1); radiopaquemarker, in 3 (23.1%; Figure 2); gas permeatingthe foreign body, in 2 (15.4%; Figure 3);calcification, in 1 (7.7%); and other findings (high and low attenuation areas), in 6(46.1%). Some masses had two or more simultaneous changes. We found peripheralenhancement of the mass (Figure 4) in 12(92.3%) of the 13 patients in whom the contrast agent was used. No other type ofenhancement was identified. A folded pattern was identified in 3 patients (18.7%),and a spongiform pattern was identified in 2 (12.5%).


Thoracic textilomas: CT findings.

Machado DM, Zanetti G, Araujo Neto CA, Nobre LF, Meirelles GS, Silva JL, Guimarães MD, Escuissato DL, Souza Jr AS, Hochhegger B, Marchiori E - J Bras Pneumol (2014)

Intravenous contrast-enhanced chest CT scan with mediastinal windowsettings. Presence of a bulky cystic mass (arrows) with regular contours andwell-defined borders, occupying and bulging the entire lower third of theright hemithorax and crossing the midline. Note peripheral contrastenhancement and typical folds (arrowheads) within the cystic mass,corresponding to the retained surgical sponge.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4263335&req=5

f01: Intravenous contrast-enhanced chest CT scan with mediastinal windowsettings. Presence of a bulky cystic mass (arrows) with regular contours andwell-defined borders, occupying and bulging the entire lower third of theright hemithorax and crossing the midline. Note peripheral contrastenhancement and typical folds (arrowheads) within the cystic mass,corresponding to the retained surgical sponge.
Mentions: All cases presented as a (round or ovoid) mass with regular contours and borders thatwere well-defined or partially defined. In 7 cases (43.76%), the mass measured nomore than 5 cm in diameter; in 4 (25.00%), it measured 10-15 cm; in 3 (18.75%), itmeasured 5-10 cm; in 1 (6.25%), it measured 15-20 cm; and in 1 (6.25%), it measured20-25 cm. Three (18.75%) of the 16 masses were homogeneous, and 13 (81.2%) wereheterogeneous. It was possible to identify images consistent with sponge-likematerial in 6 (46.1%; Figure 1); radiopaquemarker, in 3 (23.1%; Figure 2); gas permeatingthe foreign body, in 2 (15.4%; Figure 3);calcification, in 1 (7.7%); and other findings (high and low attenuation areas), in 6(46.1%). Some masses had two or more simultaneous changes. We found peripheralenhancement of the mass (Figure 4) in 12(92.3%) of the 13 patients in whom the contrast agent was used. No other type ofenhancement was identified. A folded pattern was identified in 3 patients (18.7%),and a spongiform pattern was identified in 2 (12.5%).

Bottom Line: Peripheral expansion of the mass was observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used.Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and pericardial involvement was observed in 2 (12.5%).It is important to recognize the main tomographic aspects of thoracic textilomas in order to include this possibility in the differential diagnosis of chest pain and cough in patients with a history of heart or thoracic surgery, thus promoting the early identification and treatment of this postoperative complication.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Antonio Pedro University Hospital, Fluminense Federal University, Niterói, Brazil.

ABSTRACT

Objective: The aim of this study was to analyze chest CT scans of patients with thoracic textiloma.

Methods: This was a retrospective study of 16 patients (11 men and 5 women) with surgically confirmed thoracic textiloma. The chest CT scans of those patients were evaluated by two independent observers, and discordant results were resolved by consensus.

Results: The majority (62.5%) of the textilomas were caused by previous heart surgery. The most common symptoms were chest pain (in 68.75%) and cough (in 56.25%). In all cases, the main tomographic finding was a mass with regular contours and borders that were well-defined or partially defined. Half of the textilomas occurred in the right hemithorax and half occurred in the left. The majority (56.25%) were located in the lower third of the lung. The diameter of the mass was ≤ 10 cm in 10 cases (62.5%) and > 10 cm in the remaining 6 cases (37.5%). Most (81.25%) of the textilomas were heterogeneous in density, with signs of calcification, gas, radiopaque marker, or sponge-like material. Peripheral expansion of the mass was observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used. Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and pericardial involvement was observed in 2 (12.5%).

Conclusions: It is important to recognize the main tomographic aspects of thoracic textilomas in order to include this possibility in the differential diagnosis of chest pain and cough in patients with a history of heart or thoracic surgery, thus promoting the early identification and treatment of this postoperative complication.

Show MeSH
Related in: MedlinePlus