E1622. A Case-Based Review of Chest Wall Masses with Radiologic-Pathologic Correlation
Authors
Serguei Medvedev;
Trinity Health St Joseph Mercy Oakland Hospital; Wayne State University
Huijuan Wang;
Trinity Health St Joseph Mercy Oakland Hospital; Wayne State University
Nicholas Blumenberg;
Ross University School of Medicine
Kaitlin Zaki-Metias;
Trinity Health St Joseph Mercy Oakland Hospital; Wayne State University
Stephen Seedial;
Huron Valley Radiology
Background
The chest wall contains many organ systems and various tissue types including fat, muscle, bone, cartilage, nerves, and vessels. Each of these tissues can give rise to benign or malignant pathology, resulting in a broad differential diagnosis for chest wall masses. Therefore, a multidisciplinary and multimodality approach is often necessary to reach the diagnosis. The purpose of this educational exhibit is to identify common imaging characteristics for benign and malignant chest wall masses using various imaging modalities and correlate classic radiologic findings with their pathological counterparts.
Educational Goals / Teaching Points
We have four educational goals with our exhibit. First, we review commonly encountered benign and malignant etiologies in the chest wall based on their tissue of origin. Second, we list the strengths and weaknesses of various imaging modalities in the workup of chest wall masses. Third, we identify common benign and malignant features of chest wall masses on different imaging modalities. Lastly, we solidify the presented information with several chest wall mass cases along with radiologic images and pathologic correlations.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
A multimodality approach is often used to help narrow the differential diagnosis. However, given the difficulty in diagnosing chest wall masses by imaging alone, the concurrent use of histopathology is imperative in reaching the correct diagnosis. The imaging modalities in our case based section include computed tomography (CT), ultrasound, magnetic resonance imaging, bone scan, Positron emission tomography/CT. The presented chest wall mass cases include lipoma, Langerhans cell histiocytosis, hibernoma, metastatic breast cancer to the rib, multiple myeloma, high-grade sarcoma, and more.
Conclusion
In conclusion, the workup of chest wall masses can be challenging and often requires a multidisciplinary and multimodality approach. Our educational exhibit is intended to expand or refresh differential diagnosis for chest wall masses for both radiologists in training and in practice.
