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J Thorac Cardiovasc Surg 2001;122:1046-1048
© 2001 The American Association for Thoracic Surgery

Brief Communications

Chronic expanding hematoma of the thorax

From the Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Mo.

Received for publication April 23, 2001. Accepted for publication May 2, 2001. Address for reprints: Joel D. Cooper, MD, Suite 3108 Queeny Tower, One Barnes-Jewish Hospital Plaza, St Louis, MO 63110 (E-mail: cooperjo@ msnotes.wustl.edu).

The surgical literature is replete with case reports of chronic expanding hematomas, that is, ancient hematomas, involving almost every organ system; however, a paucity of information exists concerning this entity arising from the thorax except for that found in several Japanese reports. ¹ In a majority of these cases, a remote surgical procedure for tuberculosis seemed to be the initiating factor. As with all chronic expending hematomas, symptoms may arise months or years after trauma or surgery. When first noted, these lesions frequently are thought to represent soft tissue sarcomas or other malignant tumors. ² Characteristic of this entity is the fact that our patient had a latent period of 30 years before the onset of symptoms.

Clinical summary

A 57-year-old white man had undergone a right lower lobectomy followed by a completion pneumonectomy for tuberculosis 30 years earlier. After a brief recuperative period, he had returned to a physically demanding occupation that he pursued until 1 year before admission for increasing shortness of breath in 1998. In 1986, the patient had angina and underwent a balloon angioplasty.

A chest radiograph taken in 1987 (Figure 1) revealed an opacified right pleural space with a mediastinal shift to the operative side, as would be anticipated after . . . [Full Text of this Article]

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				S. Ehara, G. L. Hwang, S. D. Moffat, J. D. Mitchell, and A. N. Leung Chronic Expanding Hematoma: Mystery or Misnomer? Am. J. Roentgenol., July 1, 2004; 183(1): 243 - 244. [Full Text] [PDF]

				K. Okubo, T. Okamoto, J. Isobe, and Y. Ueno Rupture of a chronic expanding hematoma of the thorax into lung parenchyma J. Thorac. Cardiovasc. Surg., June 1, 2004; 127(6): 1838 - 1840. [Full Text] [PDF]