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Melanoptysis: findings on CT and MRI

J Kirchner, MD 1 and E M Kirchner, MD 2

1Klinik für Radiologische Diagnostik und Nuklearmedizin and 2Medizinische Klinik I, Katholisches Marienhospital Herne, Universitätsklinikum der Ruhr Universität Bochum, Hoelkeskampring 40, 44625 Herne, Germany



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  		Figure 1. CT of a 69-year-old patient suffering from melanoptysis and severe bullous emphysema owing to coal worker's pneumoconiosis. Notice the air–fluid level within liquefied progressive massive fibrosis of 6 cm diameter. Parenchymal bands associated with local pleural thickening are visible around the lesion. Subcutaneous and mediastinal emphysema are secondary to bronchoscopy.

 


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  		Figure 2. CT of a 71-year-old patient suffering from coal worker's pneumoconiosis and melanoptysis. Notice the liquefied progressive massive fibrosis of 3.5 cm diameter in the right upper lobe (posterior segment) demonstrating a fluid level of silicotic material and mucus. A smaller massive fibrosis is seen in the posterior segment of the left upper lobe.

 


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  		Figure 3. MRI of the same patient as Figure 2Go. (a) The unenhanced T1 weighted spin echo image (TR 620 ms, TE 14 ms) of the liquefied progressive massive fibrosis (PMF) demonstrates a heterogeneous signal intensity with isointensity to the muscles in the upper part and signal loss in the dependent part of the lesion. Note the small high signal outer rim of the PMF. (b) A high signal intensity in the upper part of the lesion on the T2 weighted image (single shot fast spin echo/90 with TR>20 000 ms, TE 94 ms).

 




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