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February 6, 1978

Chest Wall Lesions Mimicking Intrapulmonary Pathological Conditions

Author Affiliations

From the Department of Diagnostic Radiology, University of Alabama in Birmingham, and University of Alabama Hospitals, Birmingham.

JAMA. 1978;239(6):535-536. doi:10.1001/jama.1978.03280330071036

THE NIPPLE shadow has been described in the literature as a chest wall normality that may, at times, be mistaken for a pulmonary nodule.1 We present here six cases of other chest wall lesions that may cause confusion in the interpretation of the chest roentgenogram unless careful systematic evaluation of both posteroanterior (PA) and lateral chest roentgenograms and adequate clinical correlation are obtained.

Report of Cases 

Case 1.—  A 50-year-old woman was admitted for a routine chest examination. Two ill-defined oval opacities were identified over the left upper lung in the PA chest roentgenogram (Fig 1, left); however, they were not seen in the lateral chest roentgenogram. The patient had neurofibromatosis. The roentgenologist examined the patient and found numerous cutaneous nodules. Therefore, a repeated chest roentgenogram was obtained with barium taped to two of these nodules, proving their chest wall location (Fig 1, right).

Case 2.—  A 30-year-old man