Images in Clinical Medicine
“Staging” Pneumothorax
N Engl J Med 2007; 356:2312May 31, 2007
- Article
A 63-year-old man was found to have a new mass in the right lung on chest radiography. Computed tomography (CT) showed a soft-tissue density in the medial aspect of the right upper lobe, closely associated with the paratracheal soft tissues (Panel A, arrow). The tracheal lumen appeared normal on bronchoscopic examination. A needle biopsy of the mass resulted in a pneumothorax. Repeat CT imaging with the patient in a right decubitus position revealed that the mass had moved with the lung and had separated completely from the trachea and mediastinum (Panel B, arrow). The patient underwent resection of the right upper lobe; pathological examination showed an adenocarcinoma that did not involve the visceral pleura. He remained well, with no evidence of recurrence, 1 year later. In this case, an unintended pneumothorax provided useful staging information.
Robert C. Hoch, M.D.
Minnesota Lung Center, Minneapolis, MN 55407
roberthoch@gmail.com
