When a mass-like lesion is seen on CT, which of the following findings support the diagnosis of rounded atelectasis?
a) An anteromedial location of the mass
b) An acute angle with the pleural margins
c) Adjacent pleural thickening
d) Localised crowding ol the pulmonary vasculature
e) Absence of enhancement following intravenous contrast
The correct answer is b) An acute angle with the pleural margins.
Rounded atelectasis is a rare form of atelectasis that presents as a mass-like lesion on imaging studies such as CT scans. When a mass-like lesion is seen on CT, an important finding that supports the diagnosis of rounded atelectasis is the presence of an acute angle with the pleural margins. This characteristic appearance is due to the folding of the lung tissue towards a fibrous scar in the pleura, creating a rounded or semilunar lesion with a sharp angle at the pleural margin.
While other findings such as an anteromedial location of the mass, adjacent pleural thickening, localized crowding of the pulmonary vasculature, and absence of enhancement following intravenous contrast can be seen in rounded atelectasis, the presence of an acute angle with the pleural margins is a key distinguishing feature that strongly supports the diagnosis of this condition.
Incorporating this knowledge into clinical practice can help radiologists and clinicians confidently diagnose rounded atelectasis based on CT findings, leading to appropriate management and follow-up strategies for patients with this unique form of lung atelectasis.