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Chest clinic
Dyspnoea from a rapidly growing intrathoracic mass
  1. Ria Itty1,
  2. Hau Chieng1,
  3. Ammoura Ibrahim2,
  4. John P Nabagiez3,
  5. John Fantauzzi4,
  6. Amit Chopra1
  1. 1 Division of Pulmonary & Critical Care Medicine, Department of Medicine, Albany Medical College, Albany, New York, USA
  2. 2 Department of Pathology, Albany Medical College, Albany, New York, USA
  3. 3 Department of Surgery, Albany Medical College, Albany, New York, USA
  4. 4 Department of Radiology, Albany Medical College, Albany, New York, USA
  1. Correspondence to Dr Hau Chieng, Division of Pulmonary & Critical Care Medicine, Department of Medicine, Albany Medical College, Albany, NY 12208, USA; hchieng1{at}gmail.com

https://doi.org/10.1136/thoraxjnl-2020-216193

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    Case presentation

    A 54-year-old man presented with progressive dyspnoea and non-productive cough for 2 months. A physical examination revealed diminished breath sounds and dullness to percussion on the right side. A preoperative chest radiograph for elective left knee arthroplasty 2 months prior to this presentation showed a 16 mm nodule in the right middle lung field (figure 1A).

    Figure 1

    (A) Chest radiograph showing a 16 mm right-sided lung nodule in the mid-lung field (red arrow). (B) Chest CTPA revealing a 4.5 cm solid, homogeneous, pleural-based mass with clear borders forming an obtuse angle with the chest wall. (C) Chest radiograph 2 months after the initial CT chest showing significant progression of the mass. (D) PET-CT chest demonstrating hypermetabolic uptake of the fluorodeoxyglucose of the large right pleural base mass. CTPA, CT pulmonary angiogram; PET-CT, positron emission tomography-CT.

    A CT pulmonary angiogram obtained 1 month after left knee arthroplasty for the complaint of dyspnoea did not reveal pulmonary embolism, however, a well-circumscribed, homogeneous 5.2 cm pleural-based mass was found in right lower haemithorax (figure 1B). A …

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    Footnotes

    • RI and HC are joint first authors.

    • RI and HC contributed equally.

    • Contributors HC and RI are leading first authors with equal contributions. HC is the corresponding author. AC is the senior author of the manuscript. HC and RI are involved in the planning, conducting, reporting, conception and design of the manuscript. All authors contributed to the writing of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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