Chronic expanding hematoma of the thorax is a specific subtype of the chronic empyema. It presents as a slowly expanding intrathoracic mass which result in dyspnea or recurrent hemoptysis. The symptoms develop months or years after tuberculous pleurisy, trauma or surgery. Usually, it shows three common findings: a giant mass lesion in the thorax, some surrounding calcifications, the absence of signs or symptoms of infection. We report a case of chronic expanding hematoma of the thorax, initially presenting as massive hemoptysis through bronchopleural fistula which resulted in radiologic findings of new air-fluid level within the previous pleural lesion filled with unknown materials.
Reid JD, Kommareddi S, Lankerani M, Park MC. Chronic expanding hematomas. A clinicopathologic entity. JAMA 1980;244:2441-2.
Kwon YS, Koh WJ, Kim TS, Lee KS, Kim BT, Shim YM. Chronic expanding hematoma of the thorax. Yonsei Med J 2007;48:337-40.
Sato M, Kosaka S, Takahashi T. Life threatening chronic expanding hematoma of the thorax. J Cardiovasc Surg (Torino) 2004;45:511-4.
Okubo K, Okamoto T, Isobe J, Ueno Y. Rupture of a chronic expanding hematoma of the thorax into lung parenchyma. J Thorac Cardiovasc Surg 2004;127:1838- 40.
Hanagiri T, Muranaka H, Hashimoto M, Nishio T, Sakai S, Ono M, et al. Chronic expanding hematoma in the chest. Ann Thorac Surg 1997;64:559-61.
Hwang GL, Moffatt SD, Mitchell JD, Leung AN. Chronic expanding hematoma of the thorax. AJR Am J Roentgenol 2003;180:1182-3.
Athanassiadi K, Reiffen HP, Dickgreber N, Laenger F, Eschenbruch CM, Wilchelmi M, et al. A different surgical approach for an intrathoracic expanding hematoma. J Thorac Cardiovasc Surg 2007;133:832-4.
Labadie EL, Glover D. Physiopathogenesis of subdural hematomas. Part 1: Histological and biochemical comparisons of subcutaneous hematoma in rats with subdural hematoma in man. J Neurosurg 1976;45:382-92.