PMC4891564_01
Five axial CT images A-E. and one coronal CT image F. showing course of catheter fragment in the right lower lobe PA four years after removal of indwelling reservoir catheter. Patient was lost to follow-up after this time, but had remained asymptomatic during course of treatment at our institution. [Powerpoint Slide]
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Although it was not noted at the time, retrospective review of the films showed the catheter compressed between the first rib and the clavicle at the costoclavicular junction (Figure 1).
Postero-anterior chest radiograph demonstrating original positioning of indwelling reservoir catheter in right subclavian vein with tip in SVC. Catheter was compressed at thoracic inlet between first rib and clavicle (arrow), consistent with "pinch-off sign". Patient is status post left mastectomy. B. Close-up view of thoracic inlet area demonstrating compression of catheter at costoclavicular junction (arrow). [Powerpoint Slide]
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Plain films at that time showed clear lungs with a catheter fragment in the right upper lobe PA (Figure 2).
Postero-anterior A. and lateral B. chest radiographs demonstrating location of catheter fragment in right upper lobe PA two years after removal of indwelling reservoir catheter (arrow). Patient was imaged during evaluation for new onset of fatigue after two-year remission of breast cancer. [Powerpoint Slide]
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The catheter was now visualized in the right middle lobe PA (Figure 3).
Postero-anterior A. and lateral B. chest radiographs showing catheter fragment in right middle lobe PA three years after removal of indwelling reservoir catheter (arrow). [Powerpoint Slide]
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Follow-up imaging six months later showed the catheter fragment in the right lower lobe PA (Figure 4).