[Twenty years later… A story of intra-thoracic textiloma]

Rev Mal Respir. 2019 Feb;36(2):214-218. doi: 10.1016/j.rmr.2018.04.009. Epub 2018 Nov 13.
[Article in French]

Abstract

Introduction: Intrathoracic textiloma is a rare complication possibly leading to misdiagnosis. It could present as haemoptysis, lung abscess, pseudo-tumour or a chronic cough.

Case report: A 65-year-old patient with a history of multiple cardiac problems and needing long-term anticoagulation, complained since 2007 of recurrent haemoptysis of increasing abundance, the etiological investigation of which was negative. A thoracic CT-scan revealed a lesion in the lingula in contact with the pericardial plates of an implanted automatic defibrillator dating from 1989. In 2016, after two failures of arterial embolization, a diagnostic and therapeutic surgical exploration was undertaken on this patient who was a high operative risk. A segmental resection revealed an intra-pulmonary textiloma on pathological examination.

Conclusion: The diagnosis of intrathoracic textiloma remains rare and its late presentation is non specific. Radiological imaging with a CT-scan and/or MRI could lead to the diagnosis. Surgery remains the reference treatment for the diagnosis and cure of intrathoracic textiloma with pathological examination, essential for confirmation. A means of prevention has to be developed because swab count is not totally reliable.

Keywords: Bronchial artery embolization; Chirurgie thoracique; Corps étranger; Défibrillateur automatique implantable; Embolisation artérielle bronchique; Foreign body; Haemoptysis; Hémoptysie; Implantable defibrillator; Textiloma; Textilome; Thoracic surgery.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Diagnosis, Differential
  • Foreign Bodies / complications
  • Foreign Bodies / diagnosis*
  • Foreign Bodies / pathology
  • Hemoptysis / diagnosis*
  • Hemoptysis / etiology
  • Humans
  • Late Onset Disorders / diagnosis
  • Late Onset Disorders / etiology
  • Late Onset Disorders / pathology
  • Lung / pathology*
  • Male
  • Surgical Mesh / adverse effects*
  • Thoracic Surgical Procedures / adverse effects*
  • Time Factors