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. 2012 Aug 1;2012(8):1.
doi: 10.1093/jscr/2012.8.1.

Multiple thoracolithiasis: An incidental finding

E Rawstorne  1 , J Muzaffar  1 , M Hawari  1 , P Naidu  1 , R Steyn  1
Affiliations

Multiple thoracolithiasis: An incidental finding

E Rawstorne et al. J Surg Case Rep. .

Abstract

Thoracoliths are rare benign intrapleural fibrotic structures with a necrotic fat core. There are 19 previous reported cases in the literature. This case report presents for the first time, a patient with two thoracoliths within the same hemithorax. Both lesions were identified incidentally in the left hemithorax by computed tomography and remained in the same position on repeat imaging. The lesions were removed by a video-assisted thoracic surgery approach. Histology revealed a 20mm and a 14mm lesion, with a fibrotic dense collagen shell surrounding a non-viable necrotic fat core. This case demonstrates that thoracolithiasis is a rare differential diagnosis for incidental multiple non-mobile lesions within the thorax.

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Figures

Fig. 1a and Fig. 1b
Fig. 1a and Fig. 1b
Coronal CT image of the thorax demonstrating nodule 1 overlying the left hemidiaphragm. Sagittal CT image of the left hemithorax demonstrating nodule 1 overlying the left hemidiaphragm
Fig. 2
Fig. 2
Transverse CT image of the thorax demonstrating nodule 2 adjacent to the mediastinum, vertebral body and descending aorta
Fig. 3
Fig. 3
Both nodules after retrieval from the left hemithorax
Fig. 4a and Fig. 4b
Fig. 4a and Fig. 4b
Cut section of the smaller nodule showing a thick, pale shell of tissue with appearances similar to cartilage. H&E stained whole-mount section (1x magnification) of the same slice of tissue
Fig. 5
Fig. 5
Thick shell of paucicellular collagen surrounding necrotic fat (40x magnification). Inset: Closer view of concentrically arranged thin layers of collagen
Fig. 6
Fig. 6
Necrotic adipose tissue centrally within the nodule (200x magnification)
See this image and copyright information in PMC

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