Circumscribed Intrapulmonary Hematoma Presenting as a "Coin" Lesion

¹ Chief, Medical Service, Veterans Administration Hospital.
² Chief, Tuberculosis Section, Veterans Administration Hospital.

1. A case of solitary, sharply circumscribed, intrapulmonary hematoma following non-penetrating injury of the chest is reported. The hematoma presented as a "coin" lesion clinically indistinguishable from a peripheral bronchogenic carcinoma or other conditions known to produce discrete pulmonary nodules.

2. The shape, the sharp outline and the tendency of these lesions to persist unchanged within the lung for long periods can apparently be ascribed to the formation of a fibrotic cyst wall around the hematoma.

3. Pulmonary hematomas of this type appear to be distinctly rare, but should be considered in the differential diagnosis of isolated discrete nodules of the lung, particularly if there is a prior history of chest trauma or evidence of rib fracture. Even though the nature of such a lesion is suspected, exploratory thoracotomy will usually be required in order to establish the correct diagnosis.