A 62-year-old woman complained of progressive shortness of breath was referred for pulmonary evaluation. Patient History 40-pack-year smoking history She had a gunshot wound in the thoracoabdominal region 28 years earlier, which had resulted in injury to the liver, left hemidiaphragm, and spleen requiring a laparotomy and splenectomy. Examination Chest radiograph showed nodularity along the left hemidiaphragm (1 st image, indicated by arrows). CT (2 nd image) revealed several small, basilar, pleural nodules on the left side, as well as a diaphragmatic defect and nodules in the splenic bed.
Technetium-99m-labeled scan with heat-damaged red cells showed concentrated areas of tracer uptake in the liver and also around the area of the left hemidiaphragm and left hemithorax. What could be the possible cause of these nodules and the signal from the left hemidiaphragm? *This case is from…
