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IMAGE REVIEW
Year : 2021  |  Volume : 1  |  Issue : 1  |  Page : 26-27

Radiology pearl


Department of Respiratory Medicine, AJ Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India

Date of Submission02-Oct-2020
Date of Decision08-Nov-2020
Date of Acceptance08-Nov-2020
Date of Web Publication28-Jan-2021

Correspondence Address:
Dr. Vishnu Sharma
Department of Respiratory Medicine, AJ Institute of Medical Sciences and Research Centre, Kuntikana, Mangalore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jalh.jalh_2_20

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How to cite this article:
Sharma V, Shruthi K. Radiology pearl. J Adv Lung Health 2021;1:26-7

How to cite this URL:
Sharma V, Shruthi K. Radiology pearl. J Adv Lung Health [serial online] 2021 [cited 2021 May 15];1:26-7. Available from: http://www.jalh.com/text.asp?2021/1/1/26/308268



This 65-year-old female, a known asthmatic, presented with history of fever, cough and increased breathlessness since 1 week during Covid pandemic. Her nasal and throat swab For everse transcription polymerase chain reaction for SARS-CoV-2 was negative. Two of her family members also had fever and cough. Chest X-ray [Figure 1] was normal. In view of high clinical suspicion of nCovid 19 pneumonia, CT scan thorax was done [Figure 2],[Figure 3],[Figure 4]. What is the radiological abnormality?
Figure 1: Chest X-ray showing cardiomegaly with increased Broncho vascular markings

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Figure 2: Computed tomography scan chest before contrast showing left breast lump

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Figure 3: Computed tomography scan chest with contrast showing left breast lump showing contrast enhancement

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Figure 4: Computed tomography scan chest showing bilateral lung secondaries

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Computed tomography (CT) scan shows a left breast lump and bilateral lung secondaries. Contrast CT was done as radiologist noted the breast lump. Biopsy confirmed left breast carcinoma. There were no radiological lesions suggestive of nCovid 19 pneumonia.

Incidental detection of breast lump in chest CT scan is not uncommon. Even though CT scan is not the modality to evaluate lesions of breast, during interpretation of chest CT scan radiologist must pay attention to detect any incidental lesions in the breast.[1] These incidentally detected lesions can be either primary or secondary breast malignancies or benign lesions. Spiculated breast lump with irregular margins, heterogeneous enhancement with contrast, infiltration to surrounding structures, associated axillary lymphadenopathy, pleural effusion and lesions in the lung suggestive of secondaries are the radiological clues for breast cancer.[2] Such incidentally detected breast lump requires biopsy for definitive diagnosis. Up to 70% of these incidentally detected lesions may be malignant.[3]

Breast cancer is the most common form of cancer in Indian women. Some of these patients may be asymptomatic and breast lump may be detected as an incidental finding on chest CT scan. Early detection of breast cancer improves the survival.[4] Hence particular attention should be given to detect any breast lump or axillary lymph nodes during interpretation of chest CT scan.

Our patient had stage 4 disease with bilateral lung secondaries. She was treated with palliative chemotherapy.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient (s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Harish MG, Konda SD, MacMahon H, Newstead GM. Breast lesions incidentally detected with CT: What the general radiologist needs to know. Radiographics 2007;27: Suppl 1:S37-51.  Back to cited text no. 1
    
2.
Son JH, Jung HK, Song JW, Baek HJ, Doo KW, Kim W, et al. Incidentally detected breast lesions on chest CT with US correlation: A pictorial essay. Diagn Interv Radiol 2016;22:514-8.  Back to cited text no. 2
    
3.
Hussain A, Gordon-Dixon A, Almusawy H, Sinha P, Desai A. The incidence and outcome of incidental breast lesions detected by computed tomography. Ann R Coll Surg Engl 2010; 92:124-6.  Back to cited text no. 3
    
4.
American Cancer Society. Cancer Facts & Figures 2020. Atlanta, Ga: American Cancer Society; 2020.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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