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Joo, Son, Jung, Park, Kim, Kim, Sohn, Yoon, Choi, Chung, Shin, and Park: A Case of Spontaneous Chronic Expanding Hematoma in the Thorax
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 65(3): 216-221.

Published online: 30 September 2008

DOI: https://doi.org/10.4046/trd.2008.65.3.216

A Case of Spontaneous Chronic Expanding Hematoma in the Thorax

Yong Won Joo, M.D.1, Chang Nam Son, M.D.1, Kyong Hee Jung, M.D.1, Hae Jeong Park, M.D.1, Sang-Heon Kim, M.D.1, Tae Hyung Kim, M.D.1, Jang Won Sohn, M.D.1, Ho Joo Yoon, M.D.1, Yo Won Choi, M.D.2, Won Sang Chung, M.D.3, Dong Ho Shin, M.D.1, Sung Soo Park, M.D.1

1Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

2Department of Diagnostic Radiology, Hanyang University College of Medicine, Seoul, Korea.

3Department of Thoracic and Cardiovascular Surgery, Hanyang University College of Medicine, Seoul, Korea.

Address for correspondence: Ho Joo Yoon, M.D. Department of Internal Medicine, Hanyang University, College of Medicine, 17, Haengdang-dong, Seongdong-gu, Seoul 133-792, Korea. Phone: 82-2-2290-8349, Fax: 82-2-2298-9183, hjyoon@hanyang.ac.kr

Received 16 July 2008       Accepted 2 August 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

A chronic expanding hematoma (CEH) in the thorax is a rare and specific condition of chronic empyema. CEHs in the thorax are often associated with tuberculosis and/or previous surgical procedures. While the incidental detection of a pleural mass and dyspnea are common clinical manifestations, a few cases present with hemoptysis. We encountered a case of CEH in the thorax. This case is unique in that it developed without a prior history of tuberculosis or surgery and presented with massive hemoptysis accompanied by bronchopleural fistula. We report the third case of CEH in the thorax in Korea with a summary of the clinical characteristics of previous cases.

Keywords: Chronic expanding hematoma, Hemoptysis, Bronchopleural fistula

Figures and Tables

Figure 1
Chest radiographs showed increased size of the right pleural lesion over 3 years. (A) Chest radiograph 3 years before admission. (B) Chest radiograph on admission.
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Figure 2
Chest CT on admission showed a large hematoma in the pleural space, which is budding to right lower lobe superior segment. It's surface is covered by dense fibrous tissue containing calcification. (A) Transverse section. (B) Coronal section.
trd-65-216-g002
Figure 3
The resected pleural lesions showed extensive fibrosis and necrosis accompanied by calcification without evidence of infection. Arrow indicates the bronchopleural fistula tract on the anterior segment of right upper lobe bronchus.
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Table 1
Clinical characteristics of the reported cases of the chronic expanding hematoma of the thorax*
trd-65-216-i001

TB: tuberculosis; ND: not described; BPF: broncho-pleural fistula, Postop.

*Case reports written in non-English were not included.

Notes

This study was supported by a grant from the Korea Health 21 R&D Project, Ministry of Health & Welfare, Korea (Grant No. 0412-CR03-0704-0001).

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