Caceres’s Corner Case 51 (Update: Solution)


Dear Friends,

Muppet wishes to present the case of a 75-year-old woman with bilateral mastectomies for carcinoma 10 and 7 years previously. Chest radiographs and CT are shown.


1. Pleural metastases
2. Mesothelioma
3. Pleural TB
4. None of the above

75-year-old woman, PA chest

75-year-old woman, PA chest

75-year-old woman, lateral chest

75-year-old woman, lateral chest

75-year-old woman, coronal CT

75-year-old woman, coronal CT

75-year-old woman, sagital CT

75-year-old woman, sagital CT

Click here for the answer to case #51

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    Jan 2013
    DISCUSSION 20 Comments

    20 Responses to : Caceres’s Corner Case 51 (Update: Solution)

    1. Elizabete says:

      None of above

    2. 4. None of the above.

    3. vijay kumar ichpujani says:

      none of the above

    4. Genchi bari italia says:

      L’emitorace sx è debolmente rx-opaco rispetto al controlaterale; inoltre in AP si nota una ipertraspareza ” a semiluna” in corrispodenza dell’arco aortico, mentre in LL si osserva una tenue opacità in sede retrosternale, delimitata posteriormente da linea pleurica.In AP sembra raddoppiata la silhouette dell’aorta discendente.Sulla TC in coronale,massa di tessuto solido che occupa il bronco lobare superiore sx.Penso allora ad atelettasia del lobo polmonare superiore sx da metastasi mammaria.

      • Jose Caceres says:

        Sorry, CT is incomplete. There was no bronchial mass. I am concerned about the pleural lesions

    5. irshad says:

      Seems like pleural thicking on left apex as well as lower left lobe……. Not sure:-)

    6. NK says:

      Pleural TB or could be an asbestosis associated pleural plaques

    7. Genchi says:

      la signora ha avuto versamenti pluerici recidivanti a sx? come sono stati trattati?(pleurodesi chimica-Talcaggio?)

    8. Dr Strangelove says:

      I think Genchi is right. This lady must have had pleural metastasis years ago (T12 is colapsed) and treated with talc pleurodesis. As a result there is an apical talc pleural nodule and fibrous hyperenhancing posterior pleural nodules.

    9. Bruno says:

      Pleural nodules are enhancing a lot. This called my attention. Generally metastasis do not have this pattern. I think this patient can have another thing (but I have no idea).

    10. Xose says:

      Focal pleural thickening on left apex and posterior costofrenic sulcus. The chest X-ray also shows some left diffuse pleural,thickening (not shown on CT). We should have an unenhancet CT to evaluate the degree of enhancement.
      I think there was a left pleural effusion at some point.

      The diagnosis might be fibrin bodies or fibrous calcifiing pseudotumor

    11. Ricardo Macareno says:

      It could be a pleural fibrous tumor. They are often pedunculated and in many cases also depend on the visceral pleura. Furthermore they are not related to exposure to asbestos and rarely calcify.

      May present intrapulmonary feigning injury and normally have a homogeneous enhancement in administering contrast CT study when they are small.

    12. Ricardo Macareno says:

      I take it back.

      (Sorry for my bad English)

    13. genchi says:

      Grazie galactico!!!!

    14. Mohamed hossameldin says:

      This pleural lesion show intense contrast enhancement , it take nearly same contrast as arteries at the arterial phase , this finding not consistent with methotheliomas , metastasis or pleural T.B . I think it is another pathology and Iam thinking of another pathology likely vascular lesions because of that intense enhancement