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Volume 135, Issue 4, Pages 1102-1106 (April 2009)
Cardiac Tumor and Renal Involvement in a Nonsmoker With Centrilobular Pulmonary Nodules Huck Chin Chew, MBBS, MMed, Cheah Hooi Ken Lee, MBBS, Foong Koong Cheah, MBBS, Soon Thye Lim, MBBS, Chian Min Loo, MBBS, FCCP CHEST Volume 135, Issue 4, Pages (April 2009) DOI: /chest Copyright © 2009 The American College of Chest Physicians Terms and Conditions
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Figure 1 Contrast-enhanced CT scan of sagittal view of kidneys in the nephrogenic phase showing bilateral symmetrical infiltration of the perirenal space (black arrows) encasing both kidneys, giving rise to a “hairy kidney” appearance. CHEST , DOI: ( /chest ) Copyright © 2009 The American College of Chest Physicians Terms and Conditions
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Figure 2 T2-weighted MRI of the heart using the half-Fourier, single-shot, spin-echo technique showing an isointense right wall thickening and lumen distortion, giving an atrial pseudomass appearance (white arrow) in addition to a pericardial effusion (black arrow). CHEST , DOI: ( /chest ) Copyright © 2009 The American College of Chest Physicians Terms and Conditions
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Figure 3 Contrast-enhanced CT scans of the thorax in the (top) lung and (bottom) soft-tissue windows, revealing multiple centrilobular nodules (curved arrows) in both lungs with septal (straight black arrows) and fissural thickening (straight white arrows), as well as diffuse patchy ground-glass changes. There was also mural circumferential thickening of the aorta (narrow black arrow on both scans), commonly referred to as coated aorta. CHEST , DOI: ( /chest ) Copyright © 2009 The American College of Chest Physicians Terms and Conditions
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Figure 4 Postconstrast T1-weighted MRI of the brain in the coronal plane showing a large irregular and heterogeneously enhanced mass (arrow) at the foramen magnum, causing compression of the fourth ventricle with obstructive hydrocephalus. CHEST , DOI: ( /chest ) Copyright © 2009 The American College of Chest Physicians Terms and Conditions
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Figure 5 Biopsy specimen from canthal xanthogranulomas showing touton-type multinucleated giant cells (black arrow). There was proliferation of large histiocytes with round-to-oval nuclei and moderate-to-abundant cytoplasm and surrounding fibrosis. Accompanying the histiocytic proliferation was infiltration of small lymphocytes and plasma cells (Diff-Quick stain [Siemens Healthcare Diagnostics; Deerfield, IL]; original ×600). CHEST , DOI: ( /chest ) Copyright © 2009 The American College of Chest Physicians Terms and Conditions
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Figure 6 Biopsy of the perinephric mass showing infiltration of foamy lipid-laden histiocytes with round-to-oval nuclei and eosinophilic cytoplasm. Accompanying the histiocytic proliferation was variable infiltration of small lymphocytes and plasma cells (Papanicolaou stain, original ×600). CHEST , DOI: ( /chest ) Copyright © 2009 The American College of Chest Physicians Terms and Conditions
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