IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Pulmonary pseudotumor

Case contributed by Davison Dzamatira
Diagnosis almost certain

Presentation

Cough and shortness of breath.

Patient Data

Age: 60 years
Gender: Male
x-ray

Homogeneous mass-like ovoid opacity in the right horizontal fissure, with confirmation on the lateral view. No confluent consolidation or lung nodules. No hilar lymphadenopathy. Normal heart size. Normal bones and soft tissues.

Case Discussion

The term pulmonary pseudotumor may be used to describe a well-circumscribed collection of pleural effusion contained within an interlobar pulmonary fissure 1. Most frequently their appearance is associated with congestive heart failure, but also other disorders like hypoalbuminemia, renal insufficiency or pleuritis 2. They are presumptively diagnosed on chest radiographs based on their typical lenticular contour and their location along the course of interlobar fissures.

If misdiagnosed as a parenchymal lung lesion, this may lead to unnecessary patient anxiety, costly imaging studies and invasive procedures including attempted tissue biopsies 1. It is important to be aware of this entity that constitutes "nodule mimics" along with other structures such as nipples, skin lesions and rib lesions among others.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.