A 50-Year-Old Man With a Cough and Painful Chest Wall Mass

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Presentation transcript:

A 50-Year-Old Man With a Cough and Painful Chest Wall Mass Quentin Jones, MBBS, Rachel Benamore, MBBChir, Eve Fryer, BMBCh, Anny Sykes, PhD CHEST Volume 145, Issue 5, Pages 1158-1161 (May 2014) DOI: 10.1378/chest.13-2039 Copyright © 2014 The American College of Chest Physicians Terms and Conditions

Figure 1 Chest radiograph showing multifocal bilateral consolidation. There is a diffuse, poorly marginated, increased opacity in the right midzone and enlargement and increased density of the soft tissues, suggestive of a chest wall mass. CHEST 2014 145, 1158-1161DOI: (10.1378/chest.13-2039) Copyright © 2014 The American College of Chest Physicians Terms and Conditions

Figure 2 The CT scan shows multifocal, bilateral, nodular, and mass-like consolidation. CHEST 2014 145, 1158-1161DOI: (10.1378/chest.13-2039) Copyright © 2014 The American College of Chest Physicians Terms and Conditions

Figure 3 CT scan showing the mass-like consolidation in the middle lobe contains areas of low attenuation in keeping with necrosis and is causing rib and costal cartilage erosion; it extends directly into the anterior chest wall, deep to the pectoralis major muscle, where there is a multiseptated low-density collection. CHEST 2014 145, 1158-1161DOI: (10.1378/chest.13-2039) Copyright © 2014 The American College of Chest Physicians Terms and Conditions

Figure 4 CT scan sagittal view showing rib erosion. CHEST 2014 145, 1158-1161DOI: (10.1378/chest.13-2039) Copyright © 2014 The American College of Chest Physicians Terms and Conditions

Figure 5 Actinomycosis forming sulfur granules (periodic acid shift diastase, original magnification × 100). CHEST 2014 145, 1158-1161DOI: (10.1378/chest.13-2039) Copyright © 2014 The American College of Chest Physicians Terms and Conditions