Thoracic textilomas: CT findings

Abstract

OBJECTIVE: The aim of this study was to analyze chest CT scans of patients with thoracic textiloma. METHODS: This was a retrospective study of 16 patients (11 men and 5 women) with surgically confirmed thoracic textiloma. The chest CT scans of those patients were evaluated by two independent observers, and discordant results were resolved by consensus. RESULTS: The majority (62.5%) of the textilomas were caused by previous heart surgery. The most common symptoms were chest pain (in 68.75%) and cough (in 56.25%). In all cases, the main tomographic finding was a mass with regular contours and borders that were well-defined or partially defined. Half of the textilomas occurred in the right hemithorax and half occurred in the left. The majority (56.25%) were located in the lower third of the lung. The diameter of the mass was ≤ 10 cm in 10 cases (62.5%) and > 10 cm in the remaining 6 cases (37.5%). Most (81.25%) of the textilomas were heterogeneous in density, with signs of calcification, gas, radiopaque marker, or sponge-like material. Peripheral expansion of the mass was observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used. Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and pericardial involvement was observed in 2 (12.5%). CONCLUSIONS: It is important to recognize the main tomographic aspects of thoracic textilomas in order to include this possibility in the differential diagnosis of chest pain and cough in patients with a history of heart or thoracic surgery, thus promoting the early identification and treatment of this postoperative complication.

Arritmia Ventricular maligna asociada a un gossypiboma. Reporte de un caso

“…La tomografía computarizada y, sobre todo, la resonancia proporcionan no solo la caracterización del tumor, sino también su localización, tamaño, relaciones, grado de extensión, invasión de tejidos adyacentes y la presencia de derrames asociados (7) . Si bien los casos reportados de gossypibomas intratorácicos describen al dolor torácico y la tos como las manifestaciones clínicas más frecuentes (8) , el síntoma que motivó la consulta en este caso fueron las palpitaciones. El primer hallazgo fue un ECG que muestra una taquicardia de complejos anchos a 180 cpm.…”

Retained surgical needle and gauze after cesarean section and adnexectomy: a case report and literature review

“… 18 They present a typical imaging appearance on computed tomography of a spongiform pattern with a radiodense linear structure, with additional characteristic features including calcified reticulate rind or an inhomogeneous, low-density mass with a thin, high-density capsule showing marked enhancement in post-contrast studies, or heterogeneous central areas in intra-abdominal gossypibomas due to gas, calcification, and radiopaque markers. 12 , 19 , 20 Ultrasound can also be used as a diagnostic tool, and can allow three types of RSIs to be classified: a poorly defined echogenic area/echogenic strip with intense posterior acoustic shadowing; a well-circumscribed cystic mass containing internal mottled contents; and a nonspecific pattern simulating a complex mass. 21 Depending on the clinical situation, magnetic resonance imaging and other relevant radiological techniques such as barium contrast studies may also be used.…”

Focal pleural tumorlike conditions: Nodules and masses beyond mesotheliomas and metastasis

“…Air bubbles may not be as prominent for intrathoracically as for intra-abdominally retained sponges. Resorption of air by the pleura is a likely explanation for this difference [63,65]. Cystic masses with an unfolded pattern, strongly suggesting the appearance of a towel, have also been described [66].…”

“…The absence of central enhancement is probably due to the presence of a clot trapped within the sponge, and peripheral enhancement is caused by an inflammatory reaction [63]. The air trapped by the foreign material is resorbed overtime, and in the absence of a radiopaque marker, lesions appear as solid masses with or without whirl-like, high-density stripes in the late postoperative period [65]. Differentiation from other masses is difficult at this stage, even with knowledge of a prior surgery [56].…”