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Nipple shadows

  • Song Soo Kim
    Affiliations
    Department of Radiology, Chungnam National University College of Medicine, Daejeon, South Korea
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  • Hyo Jin Lee
    Correspondence
    Corresponding author at: Department of Internal Medicine, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon 35015, South Korea.
    Affiliations
    Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, South Korea
    Search for articles by this author
Published:December 23, 2018DOI:https://doi.org/10.1016/j.ejim.2018.12.008

      1. Indication

      A 49-year-old female was being followed-up for malignant melanoma after surgery. Six months earlier, she had undergone amputation of right 4th finger and sentinel lymph node biopsy. A medical history and physical examination revealed no specific finding. However, the posterior-anterior radiographic examination showed a round nodular density (black arrows) in each lower lung field (Fig. 1A ), which had not previously been present.
      Fig. 1
      Fig. 1Incidentally founded nodular densities in chest X-ray.

      2. What is the diagnosis?

      2.1 Diagnosis

      The nodular densities were considered coinciding with the expected location of the both nipples. Nipple markers were placed and the examination was repeated; the both nipple markers were superimposed on the nodular densities which were interpreted as nipple shadows (Fig. 1B). Nipple shadows are known to produce nodular shadows in lower lung zones. Therefore, it is necessary to distinguish the nipple shadow from other pulmonary nodular shadow. It is usually easy to distinguish the nipple shadow from the lesion, especially by means of repeated radiographic examination with a nipple marker [
      • Polnitsky C.A.
      • Toffler R.B.
      • Sherter C.B.
      Nipple shadows in X-ray films.
      ,
      • Ohwada A.
      • Sato K.
      • Tamori Y.
      • Yamada T.
      Visible male nipple shadows in chest radiographs.
      ].

      Conflict of interest statement

      None declared.

      Acknowledgement

      This study was in part supported by a research fund of Chungnam National University.

      References

        • Polnitsky C.A.
        • Toffler R.B.
        • Sherter C.B.
        Nipple shadows in X-ray films.
        N Engl J Med. 1981; 305: 956-957
        • Ohwada A.
        • Sato K.
        • Tamori Y.
        • Yamada T.
        Visible male nipple shadows in chest radiographs.
        Respirology. 2005; 10: 111-115