Presentation
Shortness of breath and cough. Known case of congestive heart failure.
Patient Data
Chest X-ray demonstrates features of acute exacerbation of congestive heart failure, including cardiomegaly, bilateral vascular congestion and bilateral pleural effusions.
Peripheral rounded opacity noted along the minor fissure in keeping with encysted pleural fluid (pleural pseudotumor).
Case Discussion
Encysted pleural fluid (pleural pseudotumor) refers to a loculated collection of pleural fluid along the lung fissures. It can mimic a mass or malignancy, hence the name pseudotumor.
Features that are in favor of encysted pleural fluid include:
lenticular or biconvex appearance
located along the fissures (most commonly the horizontal fissure)
associated with exacerbation of congestive heart failure
usually resolves following treatment of fluid overload
If the lesion does not resolve, then CT can be performed for further evaluation.
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