Tuberc Respir Dis.  2008 Sep;65(3):216-221.

A Case of Spontaneous Chronic Expanding Hematoma in the Thorax

• Joo YW
• Son CN
• Jung KH
• Park HJ
• Kim SH
• Kim TH
• Sohn JW
• Yoon HJ
• Choi YW
• Chung WS
• Shin DH
• Park SS

Abstract

A chronic expanding hematoma (CEH) in the thorax is a rare and specific condition of chronic empyema. CEHs in the thorax are often associated with tuberculosis and/or previous surgical procedures. While the incidental detection of a pleural mass and dyspnea are common clinical manifestations, a few cases present with hemoptysis. We encountered a case of CEH in the thorax. This case is unique in that it developed without a prior history of tuberculosis or surgery and presented with massive hemoptysis accompanied by bronchopleural fistula. We report the third case of CEH in the thorax in Korea with a summary of the clinical characteristics of previous cases.

Keyword

Chronic expanding hematoma; Hemoptysis; Bronchopleural fistula

MeSH Terms

Dyspnea
Empyema
Fistula
Hematoma
Hemoptysis
Korea
Thorax
Tuberculosis

Figure

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  Figure 1 Chest radiographs showed increased size of the right pleural lesion over 3 years. (A) Chest radiograph 3 years before admission. (B) Chest radiograph on admission.

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  Figure 2 Chest CT on admission showed a large hematoma in the pleural space, which is budding to right lower lobe superior segment. It's surface is covered by dense fibrous tissue containing calcification. (A) Transverse section. (B) Coronal section.

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  Figure 3 The resected pleural lesions showed extensive fibrosis and necrosis accompanied by calcification without evidence of infection. Arrow indicates the bronchopleural fistula tract on the anterior segment of right upper lobe bronchus.

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