Presentation
Shortness of breath, prior gun shot chest/abdomen.
Patient Data
Right internal jugular catheter tip in the superior vena cava, no pneumothorax. Lobulated left apical pleural-based mass, mild left pleural thickening. Bullet fragment projects over lower thoracic spine.
Bullet fragment within the T9 vertebral body. Diffuse nodular thickening left pleura with a small spleen. Multiple soft tissue nodules left upper lateral abdominal wall.
Case Discussion
The lower thoracic/upper abdominal findings have been stable for over four years compared to a prior abdominal CT scan (not shown). There was no history of malignancy. Given the known prior gunshot injury, a presumptive diagnosis of splenosis involving the left pleura and left abdominal wall was made.