An unusual case of rounded atelectasis

Our plain-English summary of An unusual case of rounded atelectasis, by G. Geremia, R.A. Mintzer (Chest, 1984).

The study

• Authors: G. Geremia, R.A. Mintzer
• Journal: Chest
• Published: 1984;86(3):485-6
• Type of article: Case report
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001659).

Abstract

An unusual case of rounded atelectasis (RA) is described. This entity is likely to develop as a consequence of asbestos-induced pleural disease. The sine qua non of RA is a curvilinear tail extending from the inferior medial surface of a peripheral mass. Recognition of this "comet tail" prevents the necessity for surgery.

In plain English

This article is a case report about one patient with rounded atelectasis, a form of partial lung collapse that can look like a mass on X-rays. The patient was a 56-year-old male ship captain with two months of worsening shortness of breath on exertion. He had been exposed to asbestos while working in a shipyard 16 years earlier. The article does not name the asbestos type. A chest X-ray showed fluid around the right lung (a pleural effusion) and two masses in the right lung, one in the middle lobe and one in the lower lobe. Bronchography and a CT scan showed curved airways and curved "comet tail" shadows leading to each mass. Fluid was drained and a pleural biopsy was taken. The pathology findings were reported as asbestosis without malignancy. The symptoms resolved within two months, and a later X-ray showed the fluid and both collapsed areas had cleared. The authors wrote that two separate areas on the same side had not been seen before. They concluded that rounded atelectasis is likely to develop with asbestos-induced pleural disease and that recognizing the comet tail avoids invasive procedures.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (one patient)
• Who was studied: one 56-year-old male ship captain with two months of progressive shortness of breath on exertion, seen by radiologists at Northwestern University / Northwestern Memorial Hospital, Chicago; dates not given
• Exposure: asbestos exposure while working in a shipyard 16 years before symptoms began; fiber type, products and dose not stated
• Main results:
  • In this patient, the chest X-ray showed a right pleural effusion and two masses, one in the lateral segment of the middle lobe and one in the medial basilar segment of the right lower lobe
  • In this patient, bronchography showed a curved bronchus running into the lower lobe mass, and curved bronchi were also seen in the middle lobe
  • In this patient, a CT scan confirmed both masses and showed curved densities (the "comet tail") extending toward each mass
  • In this patient, the pathology findings after drainage of pleural fluid and pleural biopsy were reported as asbestosis without malignancy
  • The patient's symptoms resolved within two months, and a follow-up chest X-ray several months later showed the effusion and both areas of atelectasis had completely resolved
  • The authors stated that two separate areas of rounded atelectasis on the same side of the chest had not been seen before, although bilateral cases had been described
• The authors' conclusion: The authors concluded that rounded atelectasis is likely to develop in patients with asbestos-induced pleural disease, that the curved "comet tail" is its defining sign, and that recognizing it makes invasive procedures unnecessary. They considered this patient unusual for having two separate areas that both regressed on their own as the pleural effusion resolved.

Topics

Medical terms in this study, explained in our Lexicon: Rounded Atelectasis.

Related studies

• Rounded atelectasis due to acute exudative effusion. Spontaneous resolution — L.S. Smith, R.F. Schillaci (1984)
• Rounded atelectasis and mesothelioma — R.F. Munden, H.I. Libshitz (1998)
• Rounded atelectasis. Clinical experience with 74 patients — G. Hillerdal (1989)
• Rounded atelectasis of the lung — G.T. Stathopoulos, M.T. Karamessini, et al. (2005)
• Asbestos-related rounded atelectasis. Radiologic and mineralogic data in 23 cases — C. Voisin, F. Fisekci, et al. (1995)
• Rounded atelectasis associated with pulmonary lymphangioleiomyomatosis — K. Kishi, S. Homma, et al. (2005)

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