Zhang Zhedong, Huang Yu, Zhao Lufeng, Zhao Baiqin
Department of Thoracic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Jiefang Road 88, Hangzhou, Zhejiang, 310009, People's Republic of China.
J Cardiothorac Surg. 2025 Jan 31;20(1):111. doi: 10.1186/s13019-024-03243-3.
Traumatic Pulmonary Hematoma (TPH) is a rare consequence of blunt chest trauma, characterised by lung parenchyma laceration and subsequent hemorrhage. While less common than pulmonary contusions, TPH presents significant diagnostic challenges, particularly when it manifests as Occult Traumatic Pulmonary Hematoma (OTPH) exhibiting subtle or atypical imaging features. We report a case where OTPH was initially misdiagnosed as a posterior mediastinal tumor. A 36-year-old male with a history of minor left chest trauma presented with two oval masses in the right paravertebral region on chest computed tomography (CT). These masses were initially suspected to be mediastinal tumors.Thoracoscopic surgery revealed these lesions to be subpleural tumors in the right lower lobe, which were ultimately diagnosed as pulmonary hematomas (PH). This case highlights the necessity of including PH in the differential diagnosis of intrathoracic masses, especially when imaging findings are ambiguous. Accurate diagnosis often necessitates the integration of clinical history with advanced imaging modalities.
创伤性肺血肿（TPH）是钝性胸部创伤的一种罕见后果，其特征为肺实质撕裂及随后的出血。虽然TPH不如肺挫伤常见，但它带来了重大的诊断挑战，尤其是当它表现为隐匿性创伤性肺血肿（OTPH），呈现出细微或不典型的影像学特征时。我们报告一例最初被误诊为后纵隔肿瘤的OTPH病例。一名有轻微左胸外伤史的36岁男性，胸部计算机断层扫描（CT）显示右椎旁区域有两个椭圆形肿块。这些肿块最初被怀疑是纵隔肿瘤。胸腔镜手术显示这些病变为右下叶的胸膜下肿瘤，最终被诊断为肺血肿（PH）。该病例强调了在胸腔内肿块的鉴别诊断中纳入PH的必要性，特别是当影像学表现不明确时。准确诊断通常需要将临床病史与先进的影像学检查方法相结合。
