Localized Interlobar Effusion in Congestive Heart Failure

Abstract

Four illustrative cases of localized interlobar effusion as a manifestation of congestive heart failure are presented. The right transverse fissure was most often involved. The x-ray shadow was dense and variable in shape, frequently resembling a tumor mass, and consequently presented a diagnostic problem. Diagnosis was confirmed by demonstrating the disappearance of the "tumor" following diuresis and restoration of cardiac compensation. The disorder is apparently not rare.

Phantom Tumor of the Lung: Localized Interlobar Effusion in Congestive Heart Failure

“…Localized interlobar effusions in congestive heart failure (phantom or vanishing lung tumor/s) is/are uncommon but well known entities [ 1 – 3 ]. Due to the small number of reported cases, the incidence is difficult to estimate.…”

Multiple Left-Sided Vanishing Tumors

“…4 -6 Loculated subcostal pleural fluid simulating a tumor also has been reported, 7 but left-sided vanishing tumor is rare. 8 The pathogenesis of vanishing tumors involves the adhesion and obliteration of the pleural space due to pleuritis, thus preventing the free accumulation of fluid. In this setting, whenever hydrostatic and/or oncotic forces produce fluid at the pleural surface beyond the resorptive ability of the pleural lymphatics, a localized pleural effusion that is recognized as a vanishing tumor may result.…”

“…In addition, the pleural adhesions may be transient, as has been suggested by reports of patients with vanishing tumors who, after resolution, developed bilateral free-flowing pleural effusions on subsequent presentations. 3,7,8,10,11 Last, the right-sided predilection of vanishing tumors is best explained by the increased hydrostatic pressure and the impaired venous and lymphatic drainage that is present in the right hemithorax in congestive heart failure. 3 Vanishing tumors have a characteristic radiographic appearance; they appear crisp, well-demarcated, and very radiodense on one view, and illdefined, vague, and much less dense on the other projection, which is an important characteristic of pleural disease.…”

Tumor Appearance of the Lung in Heart Failure Patients

“…This name was given because of the appearance of a pulmonary tumor-like mass on the X-ray and the complete disappearance after the diuretic treatment. It is a rare but well known entity [1][2][3][4][5][6][7][8]. It is difficult to determine the incidence due to low number of reported cases.…”