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Oblique fissure hematoma

Case contributed by Townsville radiology training
Diagnosis probable

Presentation

Stabbed at the right shoulder blade 3 weeks ago complicated with pneumothorax. Pain at chest drain site. Afebrile.

Patient Data

Age: 40 years
Gender: Female
x-ray

Large, well demarcated ovoid homogeneous opacity 9.5 x 5.5 cm in right upper zone. Given the sharp margins it is most likely pleural in origin (versus parenchymal). The distinct shape suggest that it follows the oblique fissure.

Case Discussion

Patient has a right pulmonary pseudotumor. This caused by a hematoma along the right oblique fissure. Minimal interval change. Differentials for such findings are a fissural cyst. 

If clinically not infective, an infected hematoma is unlikely.

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