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Solitary pleural plaque

Case contributed by James Sheldon
Diagnosis almost certain

Presentation

Cough

Patient Data

Age: 90 years
Gender: Male
x-ray

 

Calcified mass projected over the right lower lobe

Prominent right paratracheal mass.

The heart size is normal. No focal consolidation. Small right pleural effusion.

ct

Calcified mass seen on CXR is actually a pleural plaque. There are two other calcified foci within the thorax: more inferiorly along the right pleura and involving the posterior mediastinal pleura.

Ectatic brachiocephalic trunk and right subclavian artery to the right of the trachea, this accounts for right paratracheal 'mass' identified on CXR.

 

Case Discussion

The density of this lesion on CXR should suggest a calcified lesion. In assessing a lung mass, ask whether this could be pleural, chest wall or elsewhere.

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