Evolution of Pulmonary Laceration

Fig. 1: Axial CT image of a trauma patient shows a pulmonary laceration (arrow) surrounded by contusion (arrowheads) in the superior segment of the left lower lobe near the paravertebral region.

Fig. 2: Follow-up chest CT at 11 days after trauma, at the same level as in Fig. 1, reveals a complete resolution of pulmonary contusion (absence of ground glass opacity), and interval evolution of a laceration (hematopneumatocele) into a hematoma (arrow).

Facts:

• Evolution: laceration --> hematoma --> complete resolution
• Most lacerations/hematomas disappear within weeks or months.
  
• Pulmonary hematoma has a similar appearance to other lung nodule, therefore can be mistaken as malignancy. A history of recent trauma, previous CT for comparison, and close follow up CT is helpful.

Reference:
Kaewlai et al. MDCT of thoracic trauma. RadioGraphics 2008 (October)