Yonsei Med J.  2007 Apr;48(2):337-340. 10.3349/ymj.2007.48.2.337.

Chronic Expanding Hematoma of the Thorax

• Kwon YS
• Koh WJ
• Kim TS
• Lee KS
• Kim BT
• Shim YM

• KMID: 1779542
• DOI: http://doi.org/10.3349/ymj.2007.48.2.337

Abstract

We report the first case in Korea of a chronic expanding hematoma, which presented as a huge mass in the pleural cavity. A 67-year-old woman exhibiting a slowly-expanding intrathoracic mass, as revealed by a chest radiograph, was admitted to our hospital. The patient had undergone a pneumonectomy 37 years earlier during treatment for pulmonary tuberculosis. Computed tomography revealed a huge mass in her right hemithorax. The differential diagnosis of this mass included chronic empyema combined with a malignancy, such as lymphoma or a soft tissue sarcoma. The tumor, which was classified as an encapsulated chronic hematoma, was removed surgically. Samples sent for histopathological and microbiological analysis revealed no evidence of neoplasia or infection. The patient was finally diagnosed with a chronic expanding hematoma of the thorax. This case is particularly rare due to the patient's development of a very large mass after undergoing treatment for tuberculosis more than 30 years earlier.

Keyword

Hematoma; thoracic neoplasms; tuberculosis; postoperative complications

MeSH Terms

Tomography, X-Ray Computed
Radiography, Thoracic
Positron-Emission Tomography
Pleural Cavity/*pathology/radiography/radionuclide imaging
Male
Humans
Hematoma/*pathology/radiography/radionuclide imaging
Dyspnea/etiology
Chronic Disease
Aged

Figure

• 

  Fig. 1 Posteroanterior chest radiograph on admission reveals total opacification of the right hemithorax with volume expansion.

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  Fig. 2 Contrast-enhanced chest CT scan reveals a huge soft-tissue attenuation mass occupying the entire right hemithoax. The heart is displaced to the left hemithorax, suggesting a volume-expanding nature of the right-sided lesion. Note multiple calcifications that are predominantly peripheral and partly central in distribution (arrows).

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  Fig. 3 Coronal PET image shows mild FDG uptake (maximum standardized uptake value = 3.7) only at the peripheral portion of the space-occupying mass in the right hemithorax (arrowheads), while most of which shows no uptake at all.

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