Rounded atelectasis of the lung: A pictorial review

Our plain-English summary of Rounded atelectasis of the lung: A pictorial review, by M. Sobocińska, B. Sobociński, A. Jarzemska, et al (Polish Journal of Radiology, 2014).

The study

• Authors: M. Sobocińska, B. Sobociński, A. Jarzemska, Z. Serafin
• Journal: Polish Journal of Radiology
• Published: 2014;79:203-9
• Type of article: Review
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Rounded atelectasis of the lung is well described in medical literature, but still difficult to diagnose. Since lesions give no clinical symptoms in patients, radiologists are often the first to recognize the round lesion in an X-ray picture or a CT scan. Rounded atelectasis is an atypical form of lung collapse that usually occurs adjacent to scarred pleura and can be mistaken for lung cancer. Patients with rounded atelectasis have a history of asbestos exposure or pleural effusion due to various causes. When characteristic imaging findings are present, the diagnosis is rarely dubious and no further investigation is necessary. However, differential diagnosis of rounded atelectasis poses a challenge to pulmonary specialists and radiologists.

In plain English

This article was a pictorial review, not an original study. Radiologists and lung specialists in Bydgoszcz, Poland, used chest X-ray and CT images and published literature to describe rounded atelectasis. This is an unusual form of lung collapse next to scarred pleura that can be mistaken for lung cancer. Citing other studies, the authors named occupational exposure to mineral dusts (asbestosis, pneumoconiosis, mixed mineral dusts) as the most common cause. They described typical CT features, including bent vessels and bronchi forming a "comet tail" sign and reduced volume of the affected lobe. They also described how to tell the lesion apart from lung cancer, metastases, granulomas and organizing pneumonia. The authors looked back at 6 cases seen at their centre over the last 3 years. The main descriptions in the radiology reports included wording such as "solid lesion of unknown nature". The authors concluded that rounded atelectasis may in most cases be diagnosed on CT without a biopsy. They also wrote that when typical radiological signs are present, particularly on CT, the report should always suggest the diagnosis. They said this applies particularly when a patient has a history of exposure to asbestos or other dusts.

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: Pictorial (narrative) review of rounded atelectasis, illustrated with chest X-ray and CT images, with a brief look back at cases from the authors' centre
• Who was studied: Published literature on rounded atelectasis, plus 6 cases whose examinations were consulted at the Kuyavian and Pomeranian Pulmonology Centre in Bydgoszcz, Poland, over the preceding 3 years
• Exposure: No exposure was measured. Citing other literature, the review described occupational exposure to mineral dusts (asbestosis, pneumoconiosis, mixed mineral dusts) and pleural effusion from various causes as causes of rounded atelectasis. No asbestos fiber types were named.
• Main results:
  • In the authors' look back at 6 cases from their centre, the main radiology report descriptions included "solid lesion of unknown nature", "lesion for further diagnostics", "contrast-enhanced lesion" or "regressing inflammatory lesion"
  • The review stated that folded, compressed vessels and bronchi entering the mass (the "comet tail" or "crab nippers" sign) are characteristic of rounded atelectasis and seen in most cases
  • The review described the volume of the affected lobe as reduced, and, according to the literature, a lesion size ranging from 2.5 to 8 cm
  • The review stated that rounded atelectasis associated with asbestosis most commonly adheres to pleural thickenings, has a lentiform or wedge-shaped (cuneiform) form with a "comet tail" sign, and reduces the volume of the affected lobe (citing other literature)
  • The review stated that rounded atelectasis is more common in men (80%) than in women
  • The authors wrote that when typical radiological signs of rounded atelectasis are present, particularly on CT, the radiology report should always suggest that diagnosis. They said this applies particularly when the lesion is accompanied by pleural fluid, when the patient has a history of exposure to asbestos or other dusts, or when the lesion is found incidentally in a patient without symptoms.
• The authors' conclusion: The authors concluded that, thanks to its typical radiological features, rounded atelectasis may in most cases be diagnosed on CT without a biopsy. They concluded that CT differentiation should include in particular peripheral lung cancer, metastases, granulomas and organizing pneumonia.

Topics

Medical terms in this study, explained in our Lexicon: Rounded Atelectasis, CT Scan, Pleura, Lung Cancer, Asbestos Exposure, Pleural Effusion, Differential Diagnosis.

Related studies

• Rounded atelectasis. Clinical experience with 74 patients — G. Hillerdal (1989)
• Rounded atelectasis and its association with asbestos-induced pleural disease — R.A. Mintzer, R.M. Gore, et al. (1981)
• The association of asbestos-induced pleural disease and rounded atelectasis — R.A. Mintzer, D.W. Cugell (1982)
• 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 due to acute exudative effusion. Spontaneous resolution — L.S. Smith, R.F. Schillaci (1984)

Browse return to medical research.