Re-expansion pulmonary edema

Case contributed by Dr Sachin T

Presentation

Presented with cough and breathlessness since 1 week.

Patient Data

Age: 15 year
Gender: Female

Gross right pleural effusion with complete collapse of right lung. Mediastinal shift to the left side. Left mild pleural effusion. Large soft tissue density mass lesion is seen in the anterior mediastinum extending to superior mediastinum and to the neck on left side. No evidence of calcifications/fat components.

Repeat CT with contrast after 2 days

CT

Right hydropneumothorax. ICD tube tip is seen outside the 5th ICS. There is re-expansion of the right lung showing diffuse ground glass opacities and smooth interlobular septal thickening. Left moderate pleural effusion.

Anterior mediastinal mass shows homogeneous enhancement. The mass lesion is encasing the superior mediastinal vessels without displacement or compression.

Case Discussion

Rapid expansion of the collapsed right lung following drainage of the right pleural effusion resulted in re-expansion pulmonary edema. Imaging features of the anterior mediastinal mass appears to be lymphoma. FNAC revealed highly cellular smear with atypical lymphoid cells.

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