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DOI: 10.1148/radiol.2451042032
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(Radiology 2007;245:285-287.)
© RSNA, 2007

Diagnosis Please

Case 1301

Prachi P. Agarwal, MD, Jean M. Seely, MD, and Frederick R. K. Matzinger, MD, FRCPC

1 From the Department of Diagnostic Imaging, the Ot-tawa Hospital, Civic Campus, 1053 Carling Ave, Ottawa, Ontario, Canada K1Y 4E9. Received November 29, 2004; revision requested January 28, 2005; revision received February 17; final version accepted March 15. Address correspondence to J.M.S. (e-mail: jeseely{at}ottawahospital.on.ca).


   HISTORY
TOP
 HISTORY
 
A 37-year-old healthy woman who did not smoke underwent computed tomography (CT) and magnetic resonance (MR) imaging of the abdomen for further work-up of a hepatic lesion that was incidentally detected at ultrasonography (US) and was thought to be an atypical liver hemangioma. US was performed to assess mild abdominal discomfort. The patient's medical history was unremarkable. The liver lesion had characteristics of a proteinaceous cyst on CT and MR images; however, upper sections of abdominal CT scans revealed a mass in the right cardiophrenic angle. Thus, CT and MR images of the chest were obtained (Figs 1–7).


Figure 1
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  		Figure 1: Frontal view of the scout radiograph obtained before chest CT.

 

Figure 2
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  		Figure 2: Transverse unenhanced CT image of the chest at the level of the cardiac ventricles.

 

Figure 3
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  		Figure 3: Transverse contrast material–enhanced (150 mL of iohexol [Omni-paque 240; Winthrop-Breon Laboratories, New York, NY]) CT image of the chest at the level of the cardiac ventricles.

 

Figure 4
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  		Figure 4: Transverse T1-weighted fast low-angle shot MR image (repetition time msec/echo time msec, 186/4.6; 70° flip angle) of the chest.

 

Figure 5
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  		Figure 5: Transverse T2-weighted fast spin-echo MR image (5000/92) of the chest.

 

Figure 6
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  		Figure 6: Transverse gadolinium-enhanced (20 mL of gadodiamide, 287 mg/mL [Omniscan; GE Healthcare, Princeton, NJ]) three-dimensional volumetric interpolated breath-hold MR image (3.55/1.6, 12° flip angle) of the chest.

 

Figure 7
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  		Figure 7: Coronal true fast imaging with steady-state precession MR image (4.44/2.22, 70° flip angle) of the chest.

 


   FOOTNOTES
 
Authors stated no financial relationship to disclose.


Submit the most likely diagnosis to http://rsna.org/dxplease (use only for submission of diagnosis). Select the case from the Active Case List for which you are submitting a diagnosis. Only one case, one name, and one diagnosis per submission. Multiple diagnoses and multiple submissions will not be considered. Deadline: Midnight U.S. Central Time, December 15, 2007. Answer will appear in the February 2008 issue. Authors wishing to submit cases for Diagnosis Please should first write to the Editor to obtain approval for the case and further information.

 





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