A rare cause of chronic cough: intrathoracic gossypiboma

Abstract

Intrathoracic gossypiboma, a retained surgical sponge in the thoracic cavity, is a rare but serious complication of thoracic surgeries. A 70-year-old man presented with an eight-month history of cough. He had undergone coronary artery bypass surgery eight years ago. The posteroanterior chest X-ray revealed a well-marginated homogeneous opacity at the left hemithorax with striped appearance in the center. Thoracic CT revealed a pleural-based mass at the left lower lobe with a hyperdense rim. After the diagnosis of gossypiboma, it was removed surgically. Although rare after thoracic surgery, gossypibomas need to be considered in the differential diagnosis in case of respiratory symptoms.

Keywords: Chronic; Cough; Thoracic Surgery.

Figure 1.

A) Posteroanterior and B) Lateral chest radiograph revealed a well-marginated homogeneous opacity in the middle-lower zone of the left hemithorax with striped appearance in the center

Figure 2.

A) Parenchymal and B) Mediastinal windows of thorax CT scan revealed a pleural-based mass with a hyperdense rim capsule in the laterobasal segment of the left lower lobe with hyperdense striped appearance in the center

Figure 3.

A and B) The removed mass contained strong smelling purulent material and a disintegrated surgical sponge

Figure 4.

Histiocyte clusters with wide and thin dense cytoplasms in fibrous stroma (H&E, 10˟)

Figure 5.

A) Foreign-body giant cells containing eccentrically placed 3-15 nuclei and fine granular cytoplasm rarely displaying demonstrable foreign material (H&E, 40˟); B) Foreign-body giant cells widely displaying demonstrable foreign material (H&E, 40˟)