Nipple shadows

Case contributed by Wedyan Yousef Alrasheed
Diagnosis certain

Presentation

Pre-employment chest radiograph.

Patient Data

Age: 30 years
Gender: Female
x-ray

A small well-defined soft tissue density nodule is seen in the right lower lung zone which is likely the nipple.

The patient was called back to repeat the chest radiograph with bilateral nipple markers.

x-ray

Markers placed over the nipples confirm that the nodules are breast nipples.

Case Discussion

Nipple shadows refer to the silhouettes of the nipples on frontal chest radiographs, which may mimic solitary pulmonary nodules (SPNs).

Nipple shadows can be differentiated from solitary pulmonary nodules on chest radiographs by being bilateral and symmetrical and having "fuzzy" margins or radiolucent "halo" or by its position between the 9th and 10th ribs posteriorly or the 5th and 6th ribs anteriorly.

In this case, the nodular opacity was more apparent on the right side which rose the suspicion of a possible solitary pulmonary nodule and a repeat chest radiograph with nipple markers was done.

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