Rib mass and pulmonary metastasis
Publication Date: 2017-02-15
3 images
Findings
There is a severe structured interstitial pattern characterized by multiple variably sized well-defined round soft tissue opaque nodules throughout all the lung lobes. The largest of these nodules is located in one of the cranial lung lobes and measures approximately 2.6 cm in diameter.
There is a large ill-defined soft tissue opaque mass in the right axillary region which extends into the thorax as an extrapleural mass. The intrathoracic portion of the mass is centered at the third right rib and there is marked aggressive lysis of the distal aspect of this rib. Irregular new bone proliferation is also identified at this region.
There is a leftward mediastinal shift on the VD view. The cardiac silhouette and pulmonary vasculature are normal. There is mild bilateral degenerative joint disease of the scapulohumeral joints.
Diagnosis
Large extrapleural mass with aggressive lysis and bone production of the right third rib is most consistent with a primary bone tumor (osteosarcoma, chondrosarcoma, or fibrosarcoma).
Severe structured interstitial pattern affecting all lung lobes is consistent with pulmonary metastatic disease likely secondary to the extrapleural mass.
Pathology Report
FNAs of the extrapleural mass were performed and osteosarcoma was diagnosed.
Notes
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