Abstract
A 27-year-old man was admitted to our hospital for the study of a mass seen on a routine chest X-ray film. The mass was in the dorsallateral area of the right lower lobe and was in contact with localized thickening of the pleura. Bronchography revealed convergence of curved bronchovascular markings around the mass. We suspected round atelectasis, but the mass increased in size gradually, so we performed right lower lobectomy. Pathological examination showed a polykaryocytic granuloma.
Mycobacterium tuberculosis was not found. The family history, however supported a diagnosis of tuberculous pleuritis.
In Japan 20 cases of round atelectasis (including our case) have been reported in the literatures. Our patient is the youngest. The most important problem of round atelectasis is its differentiation from malignant neoplasms. A definite diagnosis can be made from the roentgenographic appearance (predilection for posterior or lateral basal segment, localized pleural thickening, comet tail sign, etc.). If a definite diagnosis cannot be made, biopsy or thoracotomy is recommended.
