Presentation
History of stage IV neuroblastoma. Evaluate nasogastric tube placement.
Patient Data
There is a subtle curvilinear density in the right apex. There are additional curvilinear densities seen in the mid and lower left lung zones.
Radiograph was repeated following movement of the nasogastric tube. There are no curvilinear opacities in the right lung apex. A somewhat similar appearing linear opacity is seen at the peripheral aspect of the right lower lung zone.
Case Discussion
This is a case of an overlying density simulating a pneumothorax. The ordering clinician was concerned for a right apical pneumothorax given the curvilinear opacity and lack of lung markings beyond this region. Overlying densities were prospectively called due to a discontinuous opacity in the right lung apex, presence of several overlying curvilinear opacities bilaterally, and absence of clinical concern for a lung/thoracic pathology. The repeat radiograph again showed a curvilinear opacity, but this was in a different location overlying the right lung. Specifically, there was no opacity overlying the right lung apex.
Co-authors:
Travis Bevington, MD
Camille Dumas, DO
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