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February 13, 1967

Cor Pulmonale Due to Pulmonary Fibrosis Simulating Mediastinal Tumor

Author Affiliations

From the departments of radiology and medicine of the New York Hospital-Cornell Medical Center. Dr. Steinberg is the recipient of Career Scientist Award of the Health Research Council of New York City, contract 1-258.

JAMA. 1967;199(7):498-500. doi:10.1001/jama.1967.03120070110023

RARELY, enlarged pulmonary arteries due to cor pulmonale may be mistaken for hilar and mediastinal neoplastic masses. Herein are reported the cases of two women: one with pulmonary fibrosis, of unknown etiology, resembling the Hamman-Rich syndrome; the other with cor pulmonale secondary to an unsuspected lipoid pneumonia. In both cases, angiocardiography, by visualizing the cardiovascular structures, demonstrated the enlarged pulmonary artery and branches, suggested the diagnosis of cor pulmonale, and excluded the diagnosis of hilar and mediastinal neoplasm.1

Report of Cases 

Case 1.—  A 43-year-old woman was admitted to the hospital on Sept 8, 1964, with complaint of dyspnea. She had been in good health until two years prior to admission when a routine roentgenogram of the chest showed bilateral upper-lobe pulmonary infiltrates. Although acidfast bacilli were not found in the sputum, she was treated with antituberculous drugs for five months. Ten months prior to admission she was exposed

Steinberg, I., and Robb, G.P.:  Mediastinal and Hilar Angiocardiography in Pulmonary Disease: A Preliminary Report ,  Amer Rev Tuberc 38:557-569 ( (Nov) ) 1938.
Dines, D.E., and Clagett, O.T.:  Huge Pulmonary Artery Presenting as Primary Bronchogenic Carcinoma ,  Dis Chest 48: 331-333 ( (Sept) ) 1965.Crossref
Buckingham, W.B.; Sutton, G.C.; and Meszaros, W.T.:  Abnormalities of the Pulmonary Artery Resembling Intrathoracic Neoplasms ,  Dis Chest 40:698-704 ( (Dec) ) 1961.Crossref
Baron, E.:  Lipoid Pneumonia Due to Use of Mineral Oil as a Laxative ,  Virginia Med Monthly 77:448-450 ( (Sept) ) 1950.
Myers, J.B., and Griffith, R.L.:  Lipoid Pneumonia Due to Prolonged Ingestion of Mineral Oil ,  Dis Chest 27:677-684 ( (June) ) 1955.Crossref
Steinberg, I., and Finby, N.:  Lipoid (Mineral Oil) Pneumonia and Cor Pulmonale Due to Cardiospasm ,  Amer J Roentgen 76:108-114 ( (July) ) 1956.
Casey, J.F.:  Chronic Cor Pulmonale Associated With Lipoid Pneumonia ,  JAMA 177:896-898 ( (Sept 30) ) 1961.Crossref