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Gossypiboma in a man with persistent cough

¹ Department of Surgery, Meander Medisch Centrum, The Netherlands
² Department of Pulmonology, Meander Medisch Centrum, The Netherlands

Correspondence to:
Correspondence to:
Dr G H A Staaks
Meander Medisch Centrum, Department of Pulmonology, P O Box 1502, 3800 BM Amersfoort, The Netherlands; g.staaks{at}meandermc.nl

Keywords: chronic cough; aspergilloma; surgical sponge; gossypiboma

A 68 year old man was referred with a persistent productive cough but no haemoptysis. He did not complain of weight loss or fever and denied tobacco use or recent travel. An open lung biopsy had been performed at another hospital 8 years previously to confirm the diagnosis of tuberculosis; treatment was started but cultures remained negative.

Chest radiographs revealed a ball in a 5 cm large thin walled cavity in the right lower lobe (fig 1). When the patient was asked to bend forward the ball moved. A CT scan of the chest confirmed the radiographic findings (fig 2). Sputum examinations were negative for tuberculosis and bacteria. Precipitins against aspergillus were positive, but IgE aspergillus was negative although total IgE was slightly raised to 276 (normal range 150).

View larger version (134K): [in this window] [in a new window]   Figure 1  Chest radiograph showing a thin walled cavity in the right lower lobe containing an oval soft tissue mass.

View larger version (140K): [in this window] [in a new window]   Figure 2  CT scan showing a ball within a thin walled cavity.

To our knowledge only a few cases of thoracotomy for aspergilloma that revealed a gossypiboma (masses of retained cotton materials) have been reported.^1,2 Intrathoracic gossypibomas may also produce chest masses that radiologically resemble echinococcal cyst disease, intrapulmonary abscess, or malignant disease.^3,4

Learning point A retained surgical sponge (gossypiboma) in the pleural cavity can resemble an aspergilloma.

 

REFERENCES

1. Nomori H, Horio H, Hasegawa T, et al. Retained sponge after thoracotomy that mimicked aspergilloma. Ann Thorac Surg 1996;61:1535–6.[Abstract/Free Full Text]
2. Solaini L, Prusciano F, Bagioni P. Intrathoracic gossypiboma: a movable body within a pseudocystic mass. Eur J Cardiothorac Surg 2003;24:300.[Free Full Text]
3. Logan PM, Müller NL. CT manifestations of pulmonary aspergillosis. Crit Rev Diagn Imag 1996;37:1–37.
4. Sheehan RE, Sheppard MN, Hansell DM. Retained intrathoracic surgical swab: CT appearances. J Thorac Imaging 2000;15:61–4.[CrossRef][Medline]

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This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rijken, M J Articles by Staaks, G H A Search for Related Content PubMed PubMed Citation Articles by Rijken, M J Articles by Staaks, G H A Topic Collections Thorax Images in Thorax