Permacath (chest x-ray)

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Multiple myeloma for treatment.

Patient Data

Age: 65 years
Gender: Female
x-ray

Right internal jugular vein permacath with distal tip at the cavo-atrial junction. No pneumothorax. Well-defined but slightly lobulated opacity in the peripheral left lower zone. 

ct

Comparison with prior CT confirms left lower zone lesion is an myelomatous deposit in the left anterior 6th rib. 

Case Discussion

Permacaths (or permcaths) are a type of tunneled central venous catheter. It is a split catheter - this means that the two lumens have unequal lengths with one opening a few centimeters distal to the other giving a staggered or step tip appearance. It is often used for haemodialysis. 

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