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Round atelectasis

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

Right hemithorax longstanding pleural effusion. Patient otherwise asymptomatic.

Patient Data

Age: 60 years
Gender: Male

CT Chest

ct

There is a small right pleural effusion with associated mild diffuse pleural thickening, but no nodularity or signs of malignancy. The two right lung juxta pleural masses are consistent with round atelectasis (collapsed lung enhancing normally), showing the mild pulling of the bronchovascular structures and the thick interstitial bands in keeping with comet tail (better appreciated when scrolling on coronal and sagittal) and crow's feet (magnified axial image) signs, respectively.  The lungs are otherwise unremarkable. Prominent mediastinal lymph-nodes do not meet size criteria for suspicious lymphadenopathy. 

Case Discussion

This patient has a chronic right pleural effusion that has been previously tapped twice, with no signs of malignancy or infection. This CT scan does not show signs of underlying malignancy or features to support active infective process. The pleural-based masses have the imaging appearances of rounded atelectasis

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