CTICasesSpontaneous Pneumothorax and Obstructive Pneumonia due to Small Cell Carcinoma
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[...]. Spontaneous Pneumothorax and Obstructive Pneumonia due to Small Cell Carcinoma. CTICases. Published September 20, 2014. https://str-case-explorer.pages.dev/c/v94pu
Imaging findings
Initial radiograph shows a large left pneumothorax and collapsed, dense consolidation of the left lung. Subsequent radiographs after drain insertion show incomplete lung re-expansion with persistent consolidation. Non-contrast CT reveals a filling defect (secretions/mass) in the left bronchus, consolidated left lung, and emphysema with subpleural bullae. Bronchoscopy revealed a circumferential obstructing mass in the left bronchus and pus in the airways. Transbronchial biopsy confirmed small cell carcinoma.
Key takeaways
Small cell carcinoma can present unusually as a spontaneous pneumothorax, likely secondary to obstructive pneumonia and/or rupture of bullae in a smoker. The mass itself can be infiltrative and difficult to clearly delineate on CT, often presenting with secondary findings of obstruction and air leak.
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