Life threatening chronic expanding hematoma of the thorax.
A 73-year-old man presented with severe respiratory distress and systemic edema. Diagnosis of chronic expanding hematoma (CEH) was made through examination of past and present radiographic studies. A giant mass lesion with surrounding calcification occupying the left hemi-thorax on the chest was demonstrated via computed tomography on admission, and a chest X-ray from 8 years previously revealed evidence of tubercular pleurisy. The patient's condition deteriorated rapidly after admission, necessitating urgent operative resection of the mass. The mass consisted of fresh and organized blood and demonstrated a calcified fibrous capsule, findings that are consistent with the diagnosis of CEH. Although the patient's condition improved following operative removal of the mass, he was ultimately diagnosed with postoperative empyema secondary to bronchopleural fistula, necessitating additional surgery.
Sato
M
M
Division of Thoracic Surgery, Toronto General Hospital, Ontario, Canada. masaaki@sympatico.ca
Kosaka
S
S
Takahashi
T
T
D000368:Aged; D016638:Critical Illness; D005500:Follow-Up Studies; D006406:Hematoma / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D013902:Radiography, Thoracic; D018570:Risk Assessment; D013896:Thoracic Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D013908:Thoracotomy / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome