Limits...
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.

Show MeSH

Related in: MedlinePlus

Non-contrast-enhanced chest CT scan with mediastinal window settings.Presence of an ovoid mass in the lower third of the right hemithorax, withsoft tissue density, containing a dense linear image that corresponds to theretained surgical sponge marker (arrows). The lesion has regular contoursand maintains, in most of its extent, close contact with the pleuralsurface.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4263335&req=5

f02: Non-contrast-enhanced chest CT scan with mediastinal window settings.Presence of an ovoid mass in the lower third of the right hemithorax, withsoft tissue density, containing a dense linear image that corresponds to theretained surgical sponge marker (arrows). The lesion has regular contoursand maintains, in most of its extent, close contact with the pleuralsurface.

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)

Non-contrast-enhanced chest CT scan with mediastinal window settings.Presence of an ovoid mass in the lower third of the right hemithorax, withsoft tissue density, containing a dense linear image that corresponds to theretained surgical sponge marker (arrows). The lesion has regular contoursand maintains, in most of its extent, close contact with the pleuralsurface.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f02: Non-contrast-enhanced chest CT scan with mediastinal window settings.Presence of an ovoid mass in the lower third of the right hemithorax, withsoft tissue density, containing a dense linear image that corresponds to theretained surgical sponge marker (arrows). The lesion has regular contoursand maintains, in most of its extent, close contact with the pleuralsurface.
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