Case 65 - RSNA Publications Online

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Case 65. 1. HISTORY. A 79-year-old man had a slowly enlarging mass in the left ... revision requested March 6; revision received April 3; accepted May 23.
Radiology

Diagnosis Please Justin Q. Ly, MD Timothy G. Sanders, MD

Case 651 HISTORY A 79-year-old man had a slowly enlarging mass in the left lateral portion of his chest wall. He first noticed the mass 5 years earlier, but he ignored it until he experienced a dull ache localized in the area of the mass. Physical examination revealed a soft-tissue prominence that was firm but lacked discrete margins, associated bruits, or visible discoloration. The patient denied a history of malignancy but reported a history of an enlarged prostate. Conventional radiography, computed tomography (CT), and magnetic resonance (MR) imaging of the chest were performed (Figs 1– 6).

Figure 1.

Lateral chest radiograph.

Index term: Diagnosis Please Published online 10.1148/radiol.2282012158 Radiology 2003; 228:449 – 451 1

From the Department of Radiology and Nuclear Medicine, Wilford Hall USAF Medical Center, 759th MDTS/MTRD, 2200 Bergquist Dr, Suite 1, Lackland AFB, TX 78236-5300. Received January 14, 2002; revision requested March 6; revision received April 3; accepted May 23. Address correspondence to J.Q.L. (e-mail: [email protected]).

The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Departments of the Air Force or Defense.

E-mail the most likely diagnosis to [email protected] (use only for submission of diagnosis). Include case number, your name (as you would want it to appear in the journal), address, phone and fax numbers. Only one case, one name, and one diagnosis per e-mail submission. Multiple diagnoses, multiple submissions, submissions without a case number will not be considered. Deadline: October 15, 2003. Answer will appear in the December issue. Authors wishing to submit cases for Diagnosis Please should first write to the Editor to obtain approval for the case and further information.

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Radiology

Figure 3. Transverse T1-weighted spin-echo (SE) 466/17 (repetition time msec/echo time msec) MR image of the chest.

Figure 2. Transverse contrast material– enhanced CT scan of the chest.

Figure 4. Transverse T2-weighted fast SE 3,300/65 MR image with frequency-selective fat saturation of the chest.

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Ly and Sanders

Radiology Figure 5. Transverse T1-weighted gadolinium-enhanced SE 416/14 MR image with frequency-selective fat saturation of the chest.

Figure 6. Coronal T2-weighted fast SE 3,116/75 MR image of the left half of the thorax.

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