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Joseph Junewick, MD FACR
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Apical lung herniation

Case Detail

Anatomy: Chest
Borders
Heather Borders, MD
Diagnostic Category: Normal variant
Created: over 7 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: CR
Activities:
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History

Child presented to the ER with fever.


Case Images


Diagnosis

Apical lung herniation

Findings

Small radiolucent right neck mass arising from the right lung apex. No significant tracheal deviation. No air fluid level.

Discussion

Apical lung hernias are usually unilateral right sided and radiolucent. This may be an intermittent finding best seen during inspiration. Tracheal deviation may occur.

Lung hernias are either congenital or acquired. Acquired are more common. However, the apical type is more commonly congenital. Most in children are congenital, in particular, and tend to resolve.

Fascia at the lung apex between the sternocleidomastoid and anterior scalene becomes weak and allows the lung to herniate superiorly. The defect is often large and allows the hernia to be intermittent.

Differential includes pharyngoceles, laryngoceles and esophageal diverticula.

Reference

AJR McAdams et al. 167 (4): 927. (1996)

Contributor

John Quick MD



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