Correct!
4. All of the above
Gossypiboma, or textiloma, is the term applied to cotton-containing foreign bodies, such as sponges, swabs, and towels. Gossypibomas are the result of retained foreign bodies following surgery and may be encountered in many organ systems besides the respiratory system, including the gastrointestinal system or neurological system. Gossypibomas may be encountered asymptomatically shortly after surgery or years after the surgical procedure, although they may be associated with significant symptoms, such as debilitating pain or infection. When encountered in the thorax, gossypibomas are often encountered in the pleural space or mediastinum.
The chest radiographic appearance of gossypiboma depends on the nature of the foreign body. Surgical sponges often have a characteristic shape which allows recognition. However, surgical towels, as in this case, may have a non-specific radiographic appearance. Thoracic CT may show hyperattenuation, as in this case, although cotton-containing foreign bodies may show air density internally, usually very regular appearing, but often closely resembling abscess. A “whirl-like,” spongiform appearance is often encountered, and a lamellar hyperattenuating pattern is a clue to the nature of the abnormality. Gossypibomas may have variable appearances on imaging studies depending on the chronicity of the process, owing to the possible resorption of gas trapped within the foreign body, and the reaction they elicit in the patient. Furthermore, not all surgical textiles contain radio-opaque markers, which may make recognition on imaging difficult).
The lesion was surgically resected and proved to represent a surgical towel within the left pleural space.
Diagnosis: Gossypiboma- retained surgical towel in the left pleural space
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