Jornal Brasileiro de Pneumologia (Oct 2014)

Thoracic textilomas: CT findings

  • Dianne Melo Machado,
  • Gláucia Zanetti,
  • Cesar Augusto Araujo Neto,
  • Luiz Felipe Nobre,
  • Gustavo de Souza Portes Meirelles,
  • Jorge Luiz Pereira e Silva,
  • Marcos Duarte Guimarães,
  • Dante Luiz Escuissato,
  • Arthur Soares Souza Jr,
  • Bruno Hochhegger,
  • Edson Marchiori

DOI
https://doi.org/10.1590/S1806-37132014000500010
Journal volume & issue
Vol. 40, no. 5
pp. 535 – 542

Abstract

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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.

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