Presentation
Chest pain
Patient Data
There is increased density projected over the right lower hemithorax.
Heart size is not accurately determined on this AP projection study.
There is an old, healed left clavicle fracture.
Both breast shadows are present.
CTPA was performed.
No pulmonary embolus detected. There is minor dependant change bilaterally and centrilobular emphysematous changes in the upper lobes, better appreciated on lung windows (not shown).
No focal consolidation or pleural effusion on the right. The increased density on CT is due to a unilateral breast implant (the patient's surgical history is not clear but there is a left partial mastectomy).
In retrospect, the right costophrenic angle is clear and the apparent 'consolidation' on CXR only extends to the lateral edge of the right breast shadow.
Case Discussion
An increased density overlying a hemithorax may not be due to a lung or pleural abnormality.
Question whether the abnormality may arise within the breast/chest wall or be external to the patient. A lateral chest xray may help with this.
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