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Apical lung herniation
Case Detail
| Anatomy: Chest |
 Heather Borders, MD |
| Diagnostic Category: Normal variant |
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| Created: about 1 year ago |
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| Updated: about 1 year ago |
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| Tags:
PEDS
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| Modality/Study Types:
CR
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Activities:  PDF  ImageJA |
History
Child presented to the ER with fever.
Case Images
Diagnosis
Apical lung herniation
Findings
Small radiolucent right neck mass arising from the right lung apex. No significant tracheal deviation. No air fluid level.
Discussion
Apical lung hernias are usually unilateral right sided and radiolucent. This may be an intermittent finding best seen during inspiration. Tracheal deviation may occur.
Lung hernias are either congenital or acquired. Acquired are more common. However, the apical type is more commonly congenital. Most in children are congenital, in particular, and tend to resolve.
Fascia at the lung apex between the sternocleidomastoid and anterior scalene becomes weak and allows the lung to herniate superiorly. The defect is often large and allows the hernia to be intermittent.
Differential includes pharyngoceles, laryngoceles and esophageal diverticula.
Reference
AJR McAdams et al. 167 (4): 927. (1996)
Contributor
John Quick MD