Chest clinic PULMONARY PUZZLES Pleural nodules in a patient with a colonic tumour Edson Marchiori, 1 Rosana Souza Rodrigues, 1,2 Mario Celso Martins Reis, 1 Gláucia Zanetti, 1 Miriam Menna Barreto 1 1 Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil 2 D’Or Institute for Research and Education, Rio de Janeiro, Brazil Correspondence to Professor Edson Marchiori, Department of Radiology, Federal University of Rio de Janeiro, Rua Thomaz Cameron, 438, Valparaiso, Petrópolis, Rio de Janeiro CEP 25685.120, Brazil; edmarchiori@gmail.com Received 20 October 2013 Revised 15 November 2013 Accepted 29 November 2013 Published Online First 24 December 2013 To cite: Marchiori E, Rodrigues RS, Reis MCM, et al. Thorax 2014;69:395. CASE PRESENTATION A 58-year-old woman underwent chest CT to monitor a colonic tumour diagnosed 1 year previ- ously. Axial and coronal CT images showed mul- tiple well-circumscribed pleural-based nodules in the left lower hemithorax, and the absence of the spleen in the left upper quadrant ( figure 1). Routine blood work demonstrated no significant laboratory abnormality. The patient also had a history of a gunshot wound that transfixed the thoracoabdominal region 40 years previously. Thoracotomy was performed and disclosed mul- tiple reddish-purple nodules on the pleural surface ( figure 2). What is the most probable diagnosis of the pleural nodules? For Answer see page 398 Contributors MMB, RSR, MCMR and GZ designed the study. MMB, RSR, MCMR, GZ and EM analysed the samples and the data. MMB and EM wrote the manuscript, and all authors revised and checked it. Competing interests None. Patient consent Obtained. Ethics approval The ethics committee/institutional review board waived the approvation. Provenance and peer review Not commissioned; internally peer reviewed. Figure 1 Axial (A) and coronal (B) CT images showed multiple pleural nodules in the left hemithorax and the absence of the spleen in the left upper quadrant of the abdomen. Figure 2 Thoracotomy disclosed multiple reddish-purple nodules on the pleural surface. Marchiori E, et al. Thorax 2014;69:395. doi:10.1136/thoraxjnl-2013-204727 395 Chest clinic on June 7, 2020 by guest. Protected by copyright. http://thorax.bmj.com/ Thorax: first published as 10.1136/thoraxjnl-2013-204727 on 24 December 2013. Downloaded from