PMC6186962_01
39-year-old female with thoracolithiasis (A) An axial view of pre-contrast chest CT presenting chains of non-calcified well-defined nodules in the left hemithorax. Attenuation of nodules were 30-33 Hounsfield Units (HU). (B) In post-contrast chest CT, the nodules were not enhanced. (C) Thoracolithiasis on Chest MRI finding. (D) PET uptake was not observed.
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On axial image of chest CT, there was a chain of non-enhancing small nodules in the left hemi-diaphragmatic pleura with fat containing lesion (Fig. 1A and B). The chest magnetic resonance imaging (MRI) also showed similar findings from chest CT without chest wall invasion (Fig. 1C). On positron emission tomography-computed tomography (PET-CT) represented pleural based lesions without significant FDG uptake in left lower lobe of the lung (Fig. 1D).
(A) Intraoperation findings. (B) Gross specimen of multiple smooth glossy white round-shaped, various sized pearl-like lesion. (C) In high-power view of fat necrosis surrounded by fibrous tissue (hematoxylin-eosin stain, x40 magnification).
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During the operation, a total of twenty-five smooth glossy white round-shaped, pearl-like lesions were observed in the pleura (Fig. 2A and B). Histopathological examination showed extensive necrotic fatty tissue at its center surrounded by fibrosis, as assumed from the thoracic image findings (Fig. 2C).