Caceres’ Corner Case 137 (Update: Solution)


Dear Friends,

This is the fourth case of the “five easy pieces”. Pre-op chest radiograph for lumbar hernia of a 54-year-old woman.
What do you see? Check the image below, leave your thoughts in the comments section and come back on Friday for the answer.

PA chest

Click here for the answer to case #137

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    Apr 2016
    DISCUSSION 18 Comments

    18 Responses to : Caceres’ Corner Case 137 (Update: Solution)

    1. Eugeny says:

      Right paraspinal well-defined density in the retrocardiac region (neuroma?)

    2. sht says:

      Round soft opacity overlying right heart.

    3. Borsuk says:

      right well circumscribed density projecting over heart. Vascular or spinal origin could be suspect. Lateral viev needed.

    4. Mahmoud says:

      Right paravertebral mass, DD include :neurogenic tumor,extra medullary hematopoisis

    5. genchi bari italia says:

      ….il Professore vuole sottolineare l’importanza della LL nell’Rx torace, nonchè quelle delle linee paraspinali in AP….venerdì sapremo la probabile natura della massa….il Bari in netta ripresa e vede la serie A…..forza BARCA, supererete il momento nero….

      • Jose Caceres says:

        Even more important, checking with previous films, where the abnormality was obvious!
        The radiologist read the film as normal because he didn’t ask for a lateral, did not look properly at the PA and did not look at previous studies, which was available in the PACs
        Força Barça and forza Bari!

    6. Jabar says:

      Calcified proximal end of rib .
      Chest clear no any leation detected.

    7. Jabar says:

      Calcified of proximal end of rib to
      Vertebra .
      Chest clear

    8. Nafisa says:

      on the right is determined by the contour of the heart shadow with a rounded contour is possible pulmonary (neuroma?).

    9. Aleksandar says:

      Homogenous well diefined opacity behind right heart border with blunt right cardiophrenic angle. There is some crowding of blood vessels on the right lower hila. Also there is sligh increase of transparency of right midle and upper lobes. Could be right lower lobe atelectasis.

      • Jose Caceres says:

        The opacity is convex and the hilum is not descended. I think that these findings go against RLL atelectasis

    10. Bujar says:

      Convex opacity projected behind right heart atrium – posterior mediasitnal mass. My first opinion is focal dilated esophagus -suspect esophageal diverticula.
      The algorithm as always is lateral view then esophagogram.

    11. Bujar says:

      sorry, middle mediastinal mass.

    12. Hanan K says:

      There is widening of the inferior azygoesophageal recess and right paravertebral line. These included differential of middle or posterior mediastinal masses, its silhouetting the right cardiac border, likely middle mediastinal included DDx: hiatus hernia, oesophageal duplication cysts, malignancy or lymphadenopathy

    13. Martin says:

      Increased luceny right mid and upper zones with reduced vessel density. May reflect air trapping. Should be a chronic finding. Can’t see any definite signs to suggest atresia, mucus plugging or other structural cause for air trapping.

    14. Andrey says:

      Eosophageal mass or aortic aneurism

    15. mouhannad says:

      obliteration right paravertebral line likely due to posterior mediastinal lesion mostly neurogenic cyst or duplication or neurofibroma.