Presentation
Gradually increased in size, cutaneous irregularity, and nodularity in the right axillary region, which is extended inferiorly.
Patient Data
There is irregular/nodular thickening of the skin of the lateral chest wall on the right side (up to about 12.0 mm) with prominent subcutaneous vessels.
Multiple, enlarged lymph nodes are seen (some of them are showing internal calcifications) in both axillary regions (the largest one up to 14.0 mm, short axial dimension on the right side).
The underlying muscles of the chest wall are unremarkable. Bilateral breasts are normal.
Bronchiectatic changes are noted in the right upper lobe.
Ill-defined patches of ground glass opacity are seen bilaterally. Multiple atelectatic bands are seen on both lungs. The rest of the visualized organs are within normal limits. No bony lesion. Peri-bronchovascular tissue is normal.
Slices through the neck show an enlarged thyroid gland with an ill-defined, hypodense lesion in the left lobe (needs ultrasound correlation for TI-RADS classification).
Case Discussion
CT findings are of a cutaneous irregular and nodular lesion on the right lateral wall of the thoracic cavity with bilateral axillary lymphadenopathy as described above.
A biopsy of the lesion was done, which confirmed squamous cell carcinoma in situ (Bowen's disease) of the skin.
Other findings include inflammatory changes of the lungs and thyroid gland lesion.
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