An 86-year-old man with a history of nonischemic cardiomyopathy, chronic congestive heart failure with systolic dysfunction, and thoracic aortic disease with endovascular repair was admitted with complaints of fatigue, shortness of breath, and lower-leg swelling.
Initial impression was mildly decompensated congestive heart failure with pulmonary and peripheral congestion.
Chest radiographs on admission (Figures 1 and 2⇓) showed a sharply marginated density in the major fissure of the right upper lung zone, most compatible with a loculated pleural effusion. In addition, small bilateral pleural effusions and thoracic aortic endovascular graft were noted.
Repeat chest radiograph 5 days after treatment of the patient’s congestive heart failure (Figures 3 and 4⇓) shows complete resolution of the loculated right middle lobe effusion, consistent with a “pseudotumor” or “vanishing tumor” in the lung in the setting of successful treatment of the underlying congestive heart failure.