Findings: CT scan of the right apex shows a questionable mass posterior along the pleura. Wide windows on CT scan shows a small mass. More narrow mediastinal windows show the mass is spurious and it represents plerual thickening with fat retraction.
Diagnosis: Pleural scarring with fat retraction.
Discussion: Lung masses are best detected with a wide window setting for the parenchyma but these don't provide the best diagnostic information. Narrow windows provide a better assessment of density. Calcifications in granulomas or fat in such pleural masses can be appreciated with more narrow windows. In this case a thoracotomy was avoided.
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