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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

TC de tórax com janela para o mediastino, sem contraste intravenoso.Presença de massa ovalada no terço inferior do hemitórax direito, comdensidade de partes moles, contendo imagem linear densa que correspondeao marcador (setas) da compressa retida. A lesão tem contorno regular emantém, em sua maior extensão, íntimo contato com a superfíciepleural.
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f06: TC de tórax com janela para o mediastino, sem contraste intravenoso.Presença de massa ovalada no terço inferior do hemitórax direito, comdensidade de partes moles, contendo imagem linear densa que correspondeao marcador (setas) da compressa retida. A lesão tem contorno regular emantém, em sua maior extensão, íntimo contato com a superfíciepleural.

Mentions: Todos os casos apresentaram-se como massa (redonda ou ovalada), de contornosregulares, com limites bem definidos ou parcialmente definidos. Em 7 casos(43,76%) a massa media, no máximo, 5 cm de diâmetro; em 4 (25,00%), essa mediaentre 10-15 cm; em 3 (18,75%), entre 5-10 cm; em 1 (6,25%), entre 15-20 cm; e, em1 (6,25%), entre 20-25 cm. Três (18,75%) das 16 massas eram homogêneas, e 13(81,2%) eram heterogêneas. Foi possível identificar imagens compatíveis commaterial com aspecto de algodão de compressa em 6 (46,1%; Figura 1); marcador radiopaco, em 3 (23,1%; Figura 2); gás de permeio ao corpo estranho, em2 (15,4%; Figura 3); calcificações, em 1(7,7%); e outros achados (áreas com alta e baixa atenuação), em 6 (46,1%). Algumasmassas tinham duas ou mais alterações simultâneas. Observamos impregnaçãoperiférica da lesão (Figura 4) em 12 (92,3%)dos 13 pacientes nos quais foi administrado o meio de contraste. Nenhum outro tipode impregnação foi identificado. O padrão pregueado foi identificado em 3pacientes (18,7%), e o espongiforme, em 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)

TC de tórax com janela para o mediastino, sem contraste intravenoso.Presença de massa ovalada no terço inferior do hemitórax direito, comdensidade de partes moles, contendo imagem linear densa que correspondeao marcador (setas) da compressa retida. A lesão tem contorno regular emantém, em sua maior extensão, íntimo contato com a superfíciepleural.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f06: TC de tórax com janela para o mediastino, sem contraste intravenoso.Presença de massa ovalada no terço inferior do hemitórax direito, comdensidade de partes moles, contendo imagem linear densa que correspondeao marcador (setas) da compressa retida. A lesão tem contorno regular emantém, em sua maior extensão, íntimo contato com a superfíciepleural.
Mentions: Todos os casos apresentaram-se como massa (redonda ou ovalada), de contornosregulares, com limites bem definidos ou parcialmente definidos. Em 7 casos(43,76%) a massa media, no máximo, 5 cm de diâmetro; em 4 (25,00%), essa mediaentre 10-15 cm; em 3 (18,75%), entre 5-10 cm; em 1 (6,25%), entre 15-20 cm; e, em1 (6,25%), entre 20-25 cm. Três (18,75%) das 16 massas eram homogêneas, e 13(81,2%) eram heterogêneas. Foi possível identificar imagens compatíveis commaterial com aspecto de algodão de compressa em 6 (46,1%; Figura 1); marcador radiopaco, em 3 (23,1%; Figura 2); gás de permeio ao corpo estranho, em2 (15,4%; Figura 3); calcificações, em 1(7,7%); e outros achados (áreas com alta e baixa atenuação), em 6 (46,1%). Algumasmassas tinham duas ou mais alterações simultâneas. Observamos impregnaçãoperiférica da lesão (Figura 4) em 12 (92,3%)dos 13 pacientes nos quais foi administrado o meio de contraste. Nenhum outro tipode impregnação foi identificado. O padrão pregueado foi identificado em 3pacientes (18,7%), e o espongiforme, em 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