Journal of thoracic imaging
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We have analyzed the radiographic and computed tomographic (CT) appearance of thoracostomy (chest) tubes inadvertently placed into the lungs. We have studied the clinical sequela of such malpositioning and discussed treatment options. Cases were collected from chest CT log book reports between January 1998 and January 31, 2005 which indicated or suggested intrapulmonary thoracostomy tube placement. ⋯ Twelve patients (24%) required subsequent thoracic surgery. Intrapulmonary placement of thoracostomy tubes is probably more common than previously reported. This possibility should be considered when radiographs and CT scans are evaluated.
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Case Reports
An unusual case of thymic carcinoma with endobronchial metastases manifesting as centrilobular opacities.
We report a case of a 75-year-old man having unusual manifestation of thymic carcinoma associated with endobronchial metastases. To our knowledge, endobronchial metastases secondary to thymic carcinoma has not been reported in the literature. On high-resolution computed tomograms, the tree-in-bud centrilobular opacities caused by metastatic cells accumulating within the small bronchioles is indistinguishable from that caused by inflammatory process. Thus, in patients with thymic carcinoma and persistent tree-in-bud centrilobular opacities, endobronchial metastatic disease should be considered.
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Chronic contained rupture of aortic aneurysm is a rare but important subset of ruptured aneurysms, which has a presentation that is distinctly different from that of acute rupture. These aneurysms are usually small. Patients are hemodynamically stable, usually presenting with a long history of back or loin pain, with symptoms attributable to compressive or erosive effects. ⋯ Radiographs of the chest show large posterior mediastinal mass eroding the rib. Computed tomography scans demonstrate fusiform dilatation of the thoracoabdominal aorta with positive aortic drape sign, which is highly suggestive of a contained leak. The importance of early identification of this condition lies in the imminent danger of exsanguination, if undetected.