Pulmonary Paramediastinal Mass-like Consolidation: Differentiation of pneumonic consolidation from lymphoma with Transthoracic Doppler Ultrasonography

Abstract

Although there are lots of paramediastinal mass lesions which resemble each other, it is possible to narrow the differential diagnosis by clinical-labratory and radiologic correlation. With this unique case (5 years old girl), which seems like having left upper paramediastinal solid mass lesion but having no spesicific clinical-labratory sceneraio, we tried to differentiate pneumonic consolidation and (lymphomatous) tumoral mass by transthoracic conventional gray scale ultrasonography (US) and colour Doppler ultrasonography (CDUS) examinations. With the transthoracic high resolution US; air filled thinner bronchi also may be determined easily which is impossible to reveal at direct graphy or even at conventional CT sections. Also it is possible to conceive the normal pulmonary vasculary distrubiton through the pneumonic consolidation areas as a distinguishing sign between infiltrative consolidation and lymphoma or other consolidated mass lesions.

Keywords

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Paramediastinal Kitlesel Konsolidasyon: Transtorasik Doppler Ultrasonografi ile Lenfoma ve Pnömonik Konsolidasyon Ayırımı

Öz

Birbirine benzer görünümler yaratan bir çok paramediastinal lezyon sözkonusu olsa da klinik ve radyolojik korelasyon ile tanı spektrumu daraltılabilir. Bu özel olgu (5 yaşında kız çocuk) ile, sol üst paramediastinal kitle öntanısı ile başvuran, ancak tanısal klinik veya laboratuar bulguları bulunmayan bir pediatrik hastada, transtorasik gri skala ultrasonografi (US) ve renkli Doppler ultrasonografi (RDUS) inceleme ile tümöral (lenfoma) kitle ile pnömonik konsolidasyon ayırımı yapılabileceğini kanıtlamayı amaçladık. Transtorasik US/RDUS inceleme ile, lümeninde hava bulunan ince bronşial yapılar; direkt grafi veya kontrastsız BT'de izlenemeyecek kadar belirsiz olduğu aşamada dahi kolaylıkla tespit edilebilir. Ayrıca pulmoner vasküler dağılım da takip edilerek, konsolide bir alanın; pnömonik infiltratif konsolidasyon ya da lenfoma, akciğer kitlesi gibi kitlesel lezyonlar nedeni ile meydana geldiği ayırt edilebilir.

Anahtar Kelimeler

• Neoplazm, mediastinal, renkli doppler ultrasonografi

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