Thoracic textilomas: CT findings

J Bras Pneumol. 2014 Oct;40(5):535-42. doi: 10.1590/s1806-37132014000500010.
[Article in English, Portuguese]

Abstract

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.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Media
  • Diagnosis, Differential
  • Female
  • Foreign Bodies / diagnostic imaging*
  • Foreign Bodies / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / diagnostic imaging*
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Surgical Sponges*
  • Thoracic Surgical Procedures*
  • Tomography, X-Ray Computed

Substances

  • Contrast Media