We have observed that the companion shadow of the upper rib may be misinterpreted as a small pnemothorax or pleural plaque associated with asbestosis. To observe the radiographic characteristics of the normal companion shadow, we analyzed, on the posteroanterior(PA) chest radiographs, the companion shadow of 50 normal cases. Factors such as occurrence on each rib, the sharpness of the margin, the relative position to the rib, the shape and the thickness were observed. Also, we analyzed the displaced pleura of 4 pneumothorax cases to differentiate their frndings from the findings of normal companion shadows. On 50 normal chest radiographs, 192 compaion shadows were observed on the first to fourth ribs. In 173 of those shadows, the visceral margin of the companion shadow on the second rib simulated pneumothorax more closely than those on any othe rivs due to its apical location and thinness. In six of 50 normal cases, the companion shadow on the first or second rib showed an inw rdly convex lower margin, mimicking pleural plaque. The compaion shadow was suggested on the plain chest radiograph by the following characteristics imultiplicity(47/50), thicker than normal pleura(3/4), persistent on serial filma with the same shape and specific location(4/4).
Asbestosis ; Friends* ; Humans ; Pleura ; Pneumothorax ; Radiography, Thoracic ; Ribs* ; Thinness

On PA chest radiography, the anterior junction line(AJL) is seen to project from the upper right to the lowerleft of the upper third of the body of the sternum and represents the visceral and parietal pleura of each lungand a small quantity of mediastinal fat. In a patient with volume loss or expansion of a hemithorax, the AJL showsconsiderable shift and on PA chest radiography may mimic pneumothorax or pneumomediastimum. In such cases,widening and hyperlucency of the retrosternal space, seen on lateral view, which represents herniated lung with ashift of AJL, may be helpful for differentiation from pneumothorax or pneumomediastinum.
Humans ; Lung ; Mediastinal Emphysema ; Pleura ; Pneumothorax ; Radiography ; Sternum ; Thorax

Among lung tumors, multiple hamartomas are uncommon and multiple chondromatous hamartomas are extremely rare. In this report, we describe a patient with an interval growth of a giant chondromatous hamartoma with accompanying multiple satellite nodules in the adjacent lung and the parietal pleura. We also present the follow up chest radiograph, computed tomograph, magnetic resonance images and photographs of the operating field of the tumor with pathologic correlation.
Follow-Up Studies ; Hamartoma* ; Humans ; Lung ; Pleura ; Radiography, Thoracic

OBJECTIVE: This study presents a preliminary report on the chest radiographic and computed tomography (CT) findings of the 2019 novel coronavirus disease (COVID-19) pneumonia in Korea.MATERIALS AND METHODS: As part of a multi-institutional collaboration coordinated by the Korean Society of Thoracic Radiology, we collected nine patients with COVID-19 infections who had undergone chest radiography and CT scans. We analyzed the radiographic and CT findings of COVID-19 pneumonia at baseline. Fisher's exact test was used to compare CT findings depending on the shape of pulmonary lesions.RESULTS: Three of the nine patients (33.3%) had parenchymal abnormalities detected by chest radiography, and most of the abnormalities were peripheral consolidations. Chest CT images showed bilateral involvement in eight of the nine patients, and a unilobar reversed halo sign in the other patient. In total, 77 pulmonary lesions were found, including patchy lesions (39%), large confluent lesions (13%), and small nodular lesions (48%). The peripheral and posterior lung fields were involved in 78% and 67% of the lesions, respectively. The lesions were typically ill-defined and were composed of mixed ground-glass opacities and consolidation or pure ground-glass opacities. Patchy to confluent lesions were primarily distributed in the lower lobes (p = 0.040) and along the pleura (p < 0.001), whereas nodular lesions were primarily distributed along the bronchovascular bundles (p = 0.006).CONCLUSION: COVID-19 pneumonia in Korea primarily manifested as pure to mixed ground-glass opacities with a patchy to confluent or nodular shape in the bilateral peripheral posterior lungs. A considerable proportion of patients with COVID-19 pneumonia had normal chest radiographs.
Cooperative Behavior ; Coronavirus ; Humans ; Korea ; Lung ; Pleura ; Pneumonia ; Radiography ; Radiography, Thoracic ; Thorax ; Tomography, X-Ray Computed

Rounded atelectasis is a focal, pleural-based lesion that is the result of pleural and subpleural scarring and atelectasis of the adjacent lung tissue. We experienced a case of asbestosassociated rounded atelectasis that had developed in a 50-year-old male. When examined with routine chest radiography, the patient was shown to have an asymptomatic chest mass.Computed tomography showed a pleural-based mass with a curvilinear shape about 4.2 cmin greatest diameter in the medial basal segment of the right lower lobe. To exclude the possibilityof malignancy the mass was excised by video-assisted thoracotomy. The mass wasround and firm, and was gray and yellow in color. Microscopically, marked pleural fibrosisextended into the underlying lung parenchyme and then resulted in atelectasis. There areferruginous bodies in dense fibrous pleura.
Asbestos ; Cicatrix ; Humans ; Lung ; Lung Diseases ; Male ; Middle Aged ; Pleura ; Pulmonary Atelectasis* ; Radiography ; Thoracotomy ; Thorax

PURPOSE: To determine imaging findings among retired workers who were long-term exposed to asbestos. Lung and pleural diseases prevalence were studied on chest radiograph and HRCT. MATERIALS AND METHODS: Eighteen workers who were long-term exposedto asbestos occupationally in shipyards were examined by chest radiographs (PA and lateral view) and HRCT (high-resolution computed tomography). RESULTS: In 12 of 18 subjects (66.7%), asbestos-related pleural abnormalities were evident in diaphragmatic, lateral chest wall and costophrenic angle of the pleura on chest radiographs. The thickness of pleural plaques at the lateral chest wall varied. Diffuse pleural thickening was evident in 2 workers. Parenchymal abnormalities were not found on chest radiographs. On HRCT, pleural thickening wasobserved in 16 of 18 subjects (88.9%), in the areas of juxtavertebral, diaphragmatic, anterior, lateral, mediastinal and fissural pleura. Curvilinear subpleural lines representing early parenchymal asbestosis were found in the lower posterior lung in three of 18 subjects (16.7%). CONCLUSIONS: In long term asbestos-exposed workers, the asbestos-related pleural disease was 66.7% on chest radiographs and 88.9% on HRCT. The authors suggest that this group should be followed up periodically
Asbestos* ; Asbestosis ; Lung* ; Occupations ; Pleura ; Pleural Diseases* ; Prevalence* ; Radiography, Thoracic* ; Thoracic Wall ; Thorax*

A 44-year-old man was transferred to our department for mediastinal mass. He had suffered from only an easily fatiguable condition for 1 month. A physical examination and laboratory finding of the patient disclosed no abnormality. A chest radiograph showed a soft tissue tumor in the posterior mediastinum. It was well circumscribed and ovoid. Invasions to adjacent organs were not seen. Therefore it was though the 5th intercostal space. The tumor mass was attached to the visceral pleura of the right upper lobe by a pedicle and this pedunculated tumor laid entirely within the pleural cavity. Excision of the tumor which measured 7x7x3cm was done easily. Pathologic studies confirmed the diagnosis of localized fibrous tumor of the pleura. Localized fibrous tumor of the pleura is rare, This tumor along ith the evidence from ultrastructural and immunohistochemical studies has led most researchers to conclude that localized fibrous tumor is not of the mesothelial origin but arises in the submesothelial connective tissue.
Adult ; Connective Tissue ; Diagnosis ; Humans ; Mediastinum ; Mesothelioma ; Physical Examination ; Pleura* ; Pleural Cavity ; Pleural Neoplasms ; Radiography, Thoracic

We experienced a case of simple pneumonediastinum showing the findings of pleural effusion. Frontal chest radiography showed not only pneumomediastinum but also diffuse haziness with sharp medial margin on left lower lung field, blunting of costophrenic angle, and indistinct contour of diaphragm simulating pleural effusion. CT scan confirmed that these findings arose from the displaced pleura and the associated compression atelectasis by loculated air on the anterior mediastinum.
Diaphragm ; Lung ; Mediastinal Emphysema* ; Mediastinum ; Pleura ; Pleural Effusion* ; Pulmonary Atelectasis ; Radiography ; Thorax ; Tomography, X-Ray Computed

Unilateral absence of a pulmonary artery (UAPA) is a rare congenital anomaly that is frequently associated with other cardiovascular anomalies first reported by Fraentzel in 1968. Most patients who have no associated cardiac anomalies have only minor or absent symptoms. We experienced a case of isolated UAPA in a young female presenting hemoptysis. The chest radiograph showed a small left lung volume and high resolutional CT of chest showed multiple subpleural nodules and centrilobular nodules in parenchyma. The video-assisted thoracoscopic biopsy revealed diffuse dilated vessels in visceral pleura. The pulmonary angiogram confirmed the absence of the left main pulmonary artery.
Biopsy ; Female ; Hemoptysis* ; Humans ; Lung ; Pleura ; Pulmonary Artery* ; Radiography, Thoracic ; Thorax

Tuberculous pleural effusion (TPE) leads to residual pleural opacity (RPO) in a significant proportion of cases. The aim of this study was to investigate which TPE patients would have RPO following the treatment. This study was performed prospectively for a total of 60 TPE patients, who underwent pleural fluid analysis on the initial visit and chest radiographs and computed tomography (CT) scans before and after the administration of antituberculous medication. At the end of antituberculous medication, the incidence of RPO was 68.3% (41/60) on CT with a range of 2-50 mm. Compared with the non-RPO group, the RPO group had a longer symptom duration and lower pleural fluid glucose level. On initial CT, loculation, extrapleural fat proliferation, increased attenuation of extrapleural fat, and pleura-adjacent atelectasis were more frequent, and parietal pleura was thicker in the RPO group compared with the non-RPO group. By multivariate analysis, extrapleural fat proliferation, loculated effusion, and symptom duration were found to be predictors of RPO in TPE. In conclusion, RPO in TPE may be predicted by the clinico-radiologic parameters related to the chronicity of the effusion, such as symptom duration and extrapleural fat proliferation and loculated effusion on CT.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Pleura/*pathology ; Pleural Effusion/*complications/radiography ; Prospective Studies ; Radiography, Thoracic ; Tomography, X-Ray Computed ; Tuberculosis, Pleural/*complications/radiography