Thorax doi:10.1136/thoraxjnl-2012-202335
  • Chest clinic
  • Pulmonary puzzles

Clinical presentation

  1. Ching-Tzu Huang4
  1. 1Department of Thoracic Surgery, Taipei Medical University—Shuang Ho Hospital, New Taipei City, Taiwan
  2. 2Department of Thoracic Surgery, Lotung Poh-Ai Hospital, Yilan County, Taiwan
  3. 3Department of Pathology, Lotung Poh-Ai Hospital, Yilan County, Taiwan
  4. 4Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
  1. Correspondence to Dr. Chih-Ming Lin, Department of Thoracic Surgery, Lotung Poh-Ai Hospital, No. 83, Nanchang St., Luodong Township, Yilan County 265, Taiwan; wennie583{at}
  • Received 25 June 2012
  • Revised 8 January 2013
  • Accepted 18 January 2013
  • Published Online First 13 February 2013

A 74-year-old Asian female underwent a chest CT scan because of a pulmonary nodule observed on her chest radiograph (figure 1A). She complained of mild dyspnoea on exertion for few weeks. Her past history was significant for hypertension and obesity (body mass index 39 kg/m2). Physical examination, electrocardiography (EKG), cardiac echogram and laboratory biochemistry were all unremarkable. Chest CT scan revealed a 3.6×2.8 cm solitary nodule locating at the tip of the lingual lobe with strong vascular enhancement demonstrated during contrast phase (figure 1B). The patient was afebrile and mildly anxious, and her blood pressure was 118/64 mm Hg. Since she was symptomatic without surgical contraindication, video-assisted thoracic surgery (VATS) exploration was proceeded. Under VATS, a bright-red and …

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