Volume-expanding complications after pneumonectomy: comparison of CT findings.
The purpose of this study was to assess and characterize the computed tomographic (CT) findings of various volume-expanding complications occurring in the postpneumonectomy space. Chest CT scans, obtained in 17 patients in whom plain chest radiographs had revealed shift of the mediastinum away from the surgical side after pneumonectomy for lung cancer, were retrospectively reviewed. Recurrent neoplasm (n=6) appeared as soft-tissue mass projecting into the postpneumonectomy space and/or enlarged mediastinal lymph nodes. Empyema (n=4) was manifested by smooth thickening of the residual pleura with or without thickening of the extrapleural tissues. Hemothorax (n=4) was characterized by amorphous material of high attenuation contained within the postpneumonectomy space. Chylothorax (n=2) presented no abnormal finding except for expansion of the postpneumonectomy space. The remaining one case showed only expansion of the postpneumonectomy space and it was normalized without any treatment, which was supposed to be transient pleural fluid collection of uncertain cause. When mediastinal shift away from the surgical side occurs on plain chest radiography following pneumonectomy, CT can be helpful in differentiating various volume-expanding complications providing characteristic features.
Choe
Du Hwan
DH
Department of Radiology, Korea Cancer Center Hospital, 215-4 Gongneung-Dong, Nowon-Gu, Seoul 139-706, South Korea. choe@kcch.re.kr
Lee
Byung Hee
BH
Kim
Kie Hwan
KH
Baek
Hee Jong
HJ
Park
Jong Ho
JH
Lee
Jae Cheol
JC
D000328:Adult; D000368:Aged; D002916:Chylothorax / Q000175:diagnosis; D003937:Diagnosis, Differential; D016724:Empyema, Pleural / Q000175:diagnosis; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011013:Pneumonectomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000175:diagnosis*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*