정답은 pleural schwannoma 입니다.

 

CT 상 lesion 의 peripheral enhancement 및 central poor enhancement 보이는 상태로

 

extrapleural abscess,tbc,solitary fibrous tumor 등을 감별하여야하나 환자는 lab 및 이학소견상 특이 증상없었던 상태로 infection은 배제되었고,OP 시행하였고,  pleural schwannoma confirm되었던 case입니다.

 

Schwannoma is a neoplasm of the peripheral nerve sheath that develops from schwann's cells. Pleural involvement is uncommon, and typically originates from an intercostal nerve of the posterior-superior mediastinum to then extend along the parietal and mediastinal pleura.

CT appearance of pleural schwannomas featured well-defined margins, ovoid or round shapes, with attenuations between water and soft tissue on unenhanced imaging and heterogeneous on contrast-enhanced imaging because of cellularity differences, collagenous regions, xanthomatous changes, and cystic degeneration. Heterogeneous contrast enhancement is due to variations in the degree of cellularity and loose cellularity with prominent diffuse edematous change, which may result in minimal contrast enhancement

Clinical and CT manifestation of pleural schwannoma
Acta Radiol. 2012 Dec 1;53(10):1137-41.