Frontal Chest Radiographic Findings

There is a 3 cm, smoothly-marginated mass at the right cardiophrenic angle. The lesion was located far anterior on the lateral view. The fact that it is inseparable from the heart border and diaphragm suggests an extrapulmonic origin. However, the acute angles that the lesion makes with the cardiophrenic borders suggest an intrapulmonary process.

Differential diagnosis: Right cardiophrenic angle masses may be caused by pulmonary parenchymal diseases, mediastinal abnormalities, pleural abnormalities, and diaphragmatic hernias. Common smoothly-marginated lung masses include primary and metastatic lung cancers, hamartomas, and granulomas. Mediastinal abnormalities in this location include pericardial fat pads, pericardial cysts, juxtaphrenic lymphadenopathy, and, uncommonly, thymomas. This is a common location for foramen of Morgagni hernias. A smooth, solitary, pleural mass may be caused by solitary fibrous tumor of the pleura, pleural lipoma, pleural fibrin body, loculated pleural fluid ("pseudo-tumor"), or, uncommonly, by pleural metastases, pleural lymphoma, atypical appearing malignant mesothelioma, endometriosis, or splenosis (usually left chest).

Clinical summaryCT Scans

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