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a and b Initial chest radiograph showing a pulmonary contusion in the right lower lobe (a). A radiograph taken 6 days later showing a well-defined cavitary lesion in the right lower lobe (b).
Source publication
Posttraumatic pulmonary pseudocyst is a rare cavitary lesion lacking an epithelial lining, which develops within the pulmonary parenchyma after blunt chest trauma. Such pseudocysts develop most commonly in children and young adults. The clinical course is usually benign with spontaneous resolution of the radiologic manifestations within 2 to 4 mont...
Contexts in source publication
Context 1
... chest radiograph showed pneumothorax on the right side and a pulmonary contusion in the right lower lobe (Fig. 1 ...
Context 2
... days following the injury, the chest radiograph revealed a right lower lobe cavity without an air-fluid level (Fig. 1 b). The patient's temperature rose to 38.2 8C, the sputum became thick and mild hemoptysis developed simultaneously. CT showed a 5 × 4 cm, thin-walled cyst in the lower lobe ( Fig. 2 a and b). Bron- choscopy was performed and traces of blood were detected in the right lower lobe bronchus. Thoracic drainage produced no air and hemorrhage. ...
Context 3
... 23-year-old Dominican woman, hospitalized in the depart- ment of emergency medicine because of anterior chest pain, was sent to our department due to the finding on standard chest radiographs of a large mass on the anterior mediastinum, ini- tially diagnosed as cardiomegaly (Fig. 1). Electrocardiogram showed sinusal tachycardia. The cardiac enzymogram was nega- tive, and the echocardiogram revealed a right para-atrial and left para-ventricular voluminous mass with minimal insufficiency of the mitral valve and the aortic valve. Computed tomography (CT) scan demonstrated a voluminous mass with a maximum trans- verse ...
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Given the heterogeneous nature of pediatric chest trauma, the optimal imaging approach is tailored to the specific patient. Chest radiography remains the most important imaging modality for initial triage. The decision to perform a chest computed tomography scan should be based on the nature of the trauma, the child's clinical condition, and the in...
Citations
... 11 The imaging findings in our patient were very similar to those of a ruptured lung abscess; however, this was excluded because there was no recent history of lung infection, and markers of infection were negative. 11,12 Second, traumatic pulmonary pseudocysts develop following a high compressive force transmitted to the lung parenchyma. 13 This condition mainly occurs after blunt trauma to the chest but is also seen with penetrating wounds. ...
Thoracic trauma is commonly encountered in daily clinical practice; however, blunt thoracic trauma in patients with congenital cystic adenomatoid malformation (CCAM) is rare. CCAM rupture denotes a broad spectrum of manifestations on imaging and may be misdiagnosed as many other conditions. Consequently, this leads to inaccurate treatment and poor patient outcomes. We report the case of a girl with the initial diagnosis of a cavitary lung lesion that was likely a traumatic pulmonary pseudocyst or CCAM. The patient received medical therapy for 20 days; however, her condition did not improve. Subsequently, she underwent right lower lobectomy. Ruptured CCAM was confirmed during surgery and with histopathology. No complications occurred postoperatively, and the patient made a good recovery.
... Pulmonary hematoma refers to the presence of blood within the alveolar and interstitial spaces and is most often caused by blunt thoracic trauma. It has also been reported as a pulmonary pseudocyst and is most commonly found in children and young adults [1,2]. Blunt chest trauma rarely leads to pulmonary hematoma, and a history of trauma and chest computed tomography (CT) findings are usually sufficient to confirm its diagnosis [3]. ...
Solitary pulmonary hematoma is a rare consequence of blunt chest trauma. Moreover, there has been no reported case of solitary pulmonary hematoma radiographically diagnosed as a posterior mediastinal tumor. We present the case of a 63-year-old man who was referred for an oval-shaped opacity at the left paraspinal area on a chest X-ray. Chest computed tomography showed a well-circumscribed posterior mediastinal tumor on the left paraspinal lesion with extrapleural sign and callus formation on the left ribs posteriorly (7th to 11th ribs). The tumor was thoracoscopically confirmed to be a subpleural pulmonary tumor of the left lower lobe, and wedge resection was performed. Histological examination confirmed the diagnosis of pulmonary hematoma. On reviewing the callus formation of the ribs, which was suggestive of rib fractures, the pulmonary hematoma was determined to be traumatic in origin. The postoperative course was uneventful. We reviewed a rare case of pathologically proven traumatic solitary pulmonary hematoma. The rarity of this case is enhanced because the hematoma initially appeared to be a posterior mediastinal tumor.
... TPP is a rare cavitary lesion of the lung. TPP is an air/ fluid-filled cavity without a real epithelial lining within the pulmonary parenchyma which generally occurs after blunt chest trauma [1]. TPP is seen generally in young adults and children [1]. ...
... TPP is an air/ fluid-filled cavity without a real epithelial lining within the pulmonary parenchyma which generally occurs after blunt chest trauma [1]. TPP is seen generally in young adults and children [1]. The incidence of TPP has been reported as 2.1-8.3% ...
Purpose
Traumatic pulmonary pseudocysts (TPP) are rarely talked about, developing in less than 3% of patients with pulmonary parenchymal injuries. Resolution usually occurs within a few weeks to a few months.
Methods
A retrospective study was undertaken in 30 cases treated in Antalya Training and Research Hospital, Turkey, from January 2014 to December 2017.
Results
The 30 patients with TPP were 28 males (93.3%) and 2 females (6.7%) aged 14–64 years (mean age 31.9 years). Most of them are located in the right lower lobe (50%). The mean size of TPP was 2.07 cm. The overall resolution time for TPP was found to range from 8 to 124 days with a mean of 45.1 ± 32.9 days.
Conclusions
Computed tomography (CT) is a more beneficial than chest radiograph for early diagnosis. Physicians should control follow-up chest radiograph or CT scans until the pseudocyst resolves. Conservative treatment is acceptable in most cases, but intervention may be necessary if complications show up.
... Typically, any treatment applied is diagnostic and surgical treatment should not be considered unless complications develop such as infection, bronchial hemorrhage or rupture of the pleural space. Hemoptysis is not usuallylifethreatening and does not require surgical treatment [10]. However, to control bronchial hemorrhage, some cases requiring lobectomy have been reported. ...
Objectives: To discuss the radiological characteristics of traumatic pulmonary pseudocyst (TPP) detected by
thorax computed tomography.
Methods: Retrospective screening was made of 107 patients applied with thorax computed tomography due
to blunt thoracic trauma between 2014 and 2017 at our hospital.
Results: TPP was detected in 6 (5.6%) patients. The patients comprised 5 males and 1 female with a mean age
of 28 years (range, 15-49 years). Blunt thorax trauma was caused by traffic accidents in 4 patients and a fall
from height in 2 patients. Eleven (64.7%) of the lesions were located in the lower lobes. The most common
finding associated with TPP was ground glass opacities, which were present in all of the patients and represented
the parenchymal contusion.
Conclusion: Thorax computed tomography is an effective and reliable method for early and definitive diagnosis
of the rare development of TPP after blunt thoracic trauma.
... Chest computed tomography (CT) is important for early diagnosis [4]. Spontaneous remission is the usual outcome, but sometimes they can be complicated and surgical treatment is required [5]. ...
Posttravmatik pulmoner psödokist künt toraks travmalarının nadir bir
komplikasyonudur. Genellikle pediatrik ve genç erişkin
hastalarda görülür. Literatürde travmatik psödokistler hematom, travmatik akciğer kavitesi ve
travmatik pnömatosel olarak tanımlanmıştır. Travmatik psödokistler genellikle
iyi bir klinik prognoza sahiptir, destek tedavisi ile kendiliğinden iyileşir ve
ameliyat gerektirmezler. Bu yazıda,
trafik kazasından sonra gelişen ve konservatif tedavinin mükemmel sonuçlarla
katkıda bulunduğu iki nadir posttravmatik pulmoner psödokist olgusunu
sunuyoruz.
... In addition, early image examination should be considered in those patients with chest trauma whether there are clinical symptoms or not. 即可发现，而对于无症状患者常在成年期因其他疾 病行放射学检查时偶然发现 [4] 。创伤性因素引起的囊 肿常称之为肺假性囊肿，因其囊壁无肺组织相关的 上皮细胞而著称 [5] 。创伤性肺假性囊肿85%见于30岁 以下的青年人 [6] ，多于大的胸部创伤或胸部穿透伤后 数天出现 [7] ，创伤性肺囊肿消失时间报道不一，大多 在治疗后2周~5个月内吸收，最长达36年，总体上肺 内血肿或血气囊肿吸收过程较肺气囊肿漫长 [8][9][10] 国外如Todosijczuk等 [11] 于1958年报道2例，Zaman [12] 于2012年报道1例，上述报道病例均为中纵隔囊肿 引起的反应性胸腔积液，积液清亮，胸水胆固醇无 异常；而肺囊肿相关胆固醇性胸腔积液病例极其少 见。胆固醇胸腔积液是以胸腔积液中含有大量胆固 醇为特点的一种慢性胸膜疾病，其病因与发病过程 还不完全清楚，可能与体内或局部的脂肪代谢异常 有关 [13] ...
Pulmonary cyst is a relatively common benign lesion. It is easy to be misdiagnosed when the cyst complicated with infection. This paper reported a case of a giant traumatic pulmonary cyst (diameter 10 cm) combined with chronic infection. Firstly the patient was diagnosed as cholesterol pleurisy after undergoing thoracoscopic biopsy. With repeated pleural effusion, the patient was scheduled for right anterolateral thoracotomy, which showed a thin-walled cyst (10 cm in diameter) attached to parietal and diaphragm, with the stem of cavity originated from the right lower lobe after the cyst cavity was dissociated. Pathological examination revealed that it was apseudocyst, which could be diagnosed as traumatic pulmonary cyst combined with chronic infection according to history of trauma. After undergoing right lower lobectomy and stripping of fiberboard, the prognosis was good. Traumatic pulmonary cyst, which was discovered interval 10 years after chest trauma, was rare. Traumatic pulmonary cyst combined with cholesterol cystic fluid was very rare. Huge pulmonary cyst complicated with infection was easily misdiagnosed as loculated pleural effusion. Therefore, to be correct diagnosis and treatment, clinician must carefully ask medical history. In addition, early image examination should be considered in those patients with chest trauma whether there are clinical symptoms or not.
... TPP is an air/fluid filled cavity without a true epithelial lining within the pulmonary parenchyma which usually happens after blunt chest traumas. TPP is seen most commonly in young adults and children [2]. Computed tomography of the thorax is an important step for early diagnosis. ...
... Spontaneous remission is the usual outcome; therapy is usually supportive unless complications such as pneumothorax or infection of the cavitary lesion arise. In some cases even surgery is needed [2,5]. We here report a post-traumatic pulmonary pseudocyst, which is a rare case, happened after after a blunt chest trauma due to a traffic accident. ...
Post-traumatic pulmonary pseudocyst (TPP) is an uncommon cavitary lesion of the lung. TPP is an air/fluid filled cavity without a true epithelial lining within the pulmonary parenchyma. TPPs usually occur following a motor vehicle accident or fall. Here we report a case of TPP which occurred after blunt chest trauma after a traffic accident. The chest X-ray few hours after the accident revealed mass/cyst like lesion on the right lover zone. Computed tomography of the thorax revealed bilateral cystic lesions on the parenchyma. The patient was treated conservatively with antibiotherapy. He was asymptomatic thereafter, and the traumatic pulmonary pseudocyst radiologically was completely resolved three months later. TPP might be confused with other cystic and cavitary lesions of the lung but radiological rapid onset is important in the differential diagnosis. J Clin Exp Invest 2014; 5 (2): 304-306
... Esta entidad es infrecuente y se presenta más en niños y adultos menores de 20 años. Se trata de una lesión benigna que se resuelve sin ningún tratamiento específico (1,2). Presentamos el caso de un niño con el antecedente de un trauma y diagnóstico de pseudoquiste pulmonar. ...
... Se desconoce con exactitud el mecanismo por el cual se produce esta lesión, pero se cree que la pared torácica de los niños y los adultos jóvenes, por ser más elástica y flexible, permite la transmisión más eficiente de la energía cinética a las estructuras intratorácicas como el parénquima pulmonar (2,6); como resultado, la energía transmitida durante el impacto produce una compresión torácica que podría dañar directa o indirectamente dicho parénquima (6). Una lesión por desgarro o corte en el parénquima pulmonar es el episodio inicial para la formación del NCT, que es más probable cuando la lesión se comunica directamente con la vía aérea; en cambio, si no existe tal comunicación es probable que se forme un hematoma pulmonar (2). ...
... La mayoría de los NCT aparecen dentro de las primeras 12 horas después del trauma; sin embargo, pueden desarrollarse tan pronto como una hora después del accidente o varios días después (2). El paciente puede estar asintomático o manifestar síntomas sutiles o poco específicos desde el mismo momento del trauma o pocas horas o varios días después (10). ...
El Pseudoquiste pulmonar secundario a trauma cerrado de tórax, es una rara lesión cavitada en el parénquima pulmonar que carece de revestimiento epitelial. Es más frecuente en niños y adolescentes en quienes la pared torácica es menos rígida. Las manifestaciones clínicas usualmente son benignas y se resuelve espontáneamente de 2 a 4 meses luego del trauma. En este caso, presentamos la evolución de un paciente que tuvo un trauma cerrado de tórax en calidad de peatón, luego del cual aparece una lesión quística en el parénquima pulmonar, sin sintomatología muy evidente, con posterior resolución de la lesión en un paciente ya asintomático.
... The size, shape, and nature of the wall of the TPP, unlike those of other kinds of cystic or cavitary lesions, change in a relatively short time. Thus, a series of chest X-rays taken over several days can be useful to differentiate TPP from other kinds of lesions, and no extensive examination is necessary [9]. The history of trauma usually delineates any contusion, but if the cavitary lesion in question does not decrease with time, other etiologies must be considered [10,11]. ...
Introduction
Post-traumatic pulmonary pseudocyst is an uncommon cavitary lesion of the lung and develops after blunt chest trauma and even more rarely following penetrating injuries. It is generally seen in young adults presenting with cough, chest pain, hemoptysis, and dyspnea. Post-traumatic pulmonary pseudocyst should be included in the differential diagnosis of cavitary pulmonary lesions. We describe the case of a 60-year-old Caucasian Greek woman who sustained traumatic pulmonary pseudocyst with hemopneumothorax due to a blunt chest trauma after a traffic accident.
Case presentation
After a traffic accident, a 60-year-old Caucasian Greek woman sustained a hemopneumothorax due to a blunt chest trauma. There was evidence of an extensive contusion in the posterior and lateral segments of the right lower lobe, a finding that was attributed to an early sign of a cavitation, and the presence of a thin-walled air cavity was detected on the anterior segment of the right lower lobe in the control computed tomography taken 24 hours after admission. Our patient was treated by catheter aspiration, and the findings of computed tomography evaluation about one month later showed complete resolution of one of the two air-filled cavitary lesions. The second pseudocyst also disappeared completely, as shown by the control computed tomography scan performed six months later.
Conclusions
Traumatic pulmonary pseudocyst is a rare complication of blunt chest trauma, and computed tomography is a more valuable imaging technique than chest radiograph for early diagnosis.
... Chest radiography, especially obtained in the supine position, does not always allow the identification of the PPPs. 2,8 This could be related to the presence of the associated pulmonary contusion, unilateral pneumothorax, hemothorax, or hemopneumothorax. Several days later, the cavitary lesions could be detected radiologically because of the resolution of the lung contusion or hemopneumothorax. ...
... These lesions were formed in a way that a tear force applied to the pulmonary parenchyma leading to a lacuna, which was filled with air, blood, or exudate. 7,8,10 All the pulmonary hematomas in our patients were developed from air-filled cavity or air-fluid cavity, but not all air-filled cavity or air-fluid cavity turned into hematoma. Because the air-fluid cavity was significantly larger than air-filled cavities and pulmonary hematomas, our hypothesis is that the size of the lesions could be influenced by the formation of hematoma. ...
BACKGROUND: Posttraumatic pulmonary pseudocyst (PPP) is a complication of blunt chest trauma and poorly documented. A retrospective review of PPPs observed during the past 6 years in our hospitals is presented in this report. METHODS: We retrospectively studied the serial chest computed tomographic scans and clinical data of 33 consecutive patients with PPPs. RESULTS: Fifty-three PPPs from 33 patients were found. Thirty-six PPPs were located in the subpleural pulmonary parenchyma, whereas others were located in the pulmonary parenchyma near other harder structures. Follow-up examinations demonstrated that air-filled cavities and air-fluid cavities could turn into pulmonary hematomas and eventually resolved without specific treatment. The PPPs were resolved in 11 to 82 days. The resolving time of air-fluid cavity (mean, 47.5 days) was significantly longer than the resolving time of air-filled cavity (mean, 16.3 days; p = 0.001). Three patients died of acute respiratory distress syndrome or head trauma. No patient died of PPP. Twelve patients with serious pneumothorax, hemothorax, or both were cured with surgical hemostasis and/or drainage. Eighteen patients resolved without specific treatment. CONCLUSION: Computed tomography increased the frequency of PPP diagnosis and accurately demonstrated the characteristics of the lesions. Air-filled pseudocysts resolved more quickly than those containing fluid. The outcome of PPPs can be favorable without specific treatment. PPP does not require follow-up CT scan or intervention in the absence of complications. LEVEL OF EVIDENCE: Therapeutic study, level V.
