Case of the Week: December 5-December 12, 2019

History: 33 y.o. male. Heart failure.

Evaluate for pacemaker placement

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Case Details

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This case illustrates two signs in chest imaging: a pseudomass sign and a flat waist sign. Both are caused by left lower lobe collapse. The flat waist sign is flattening of the left heart border and downward displacement of the left hilum. A pseudomass is an appearance of an underlying lesion that is not real, and is due to other factors, in this case, left lower lobe collapse. A cardiac MRI (axial VIBE attached) was performed within 10 days of this chest radiograph, and shows no retrocardiac mass, only left lower lobe atelectasis and a trace left effusion.

Answer

Diagnosis: The chest radiograph demonstrates a left retrocardiac 4 cm mass-like opacity.

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Correct answers by users

Radiology Medicine/Pulmonary
VCU Resident
Others
  • Akitoshi InoueUnited States of America
  • Maw OoMyanmar
    VCU Department of Thoracic Imaging Virginia Commonwealth University VCU Medical Center