Lung cancer with rib fracture

Case contributed by Dr Brendon Friesen

Presentation

Chest infection

Patient Data

Age: 85
Gender: Male
X-ray

Multiple left sided pulmonary and pleural masses.

Healing pathological left 6th lateral rib fracture.

Large mass projecting over left heart border.

Right middle lobe ground-glass opacities.

Hyperinflated lungs.

CT

Multiple left sided pulmonary and pleural mass lesions.  No right sided pulmonary mass.

Mass contacting descending aorta (correlating with left retrocardiac mass on radiograph).

Some of the apparent pleural based lesions demonstrate CT angiogram sign. A few of the pleural lesions are associated with lucent defects in left sided ribs. Evidence of healing of left 6th rib pathological rib fracture.

Severe pulmonary emphysema. No pleural effusion. No pulmonary embolus. Calcified subcarinal lymph nodes.

Case Discussion

Multiple left sided pulmonary and pleural mass lesions. Associated pathological rib fracture. Severe pulmonary emphysema.

Findings compatible with metastatic primary lung carcinoma.

Pulmonary metastasis from an unknown primary is a differential, although less likely as no right sided mass is present.

The patient apparently had known lung carcinoma, presumably diagnosed at St Elsewhere (no prior imaging or pathology available).

 

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Case information

rID: 28854
Case created: 16th Apr 2014
Last edited: 2nd Nov 2016
System: Chest
Inclusion in quiz mode: Included

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