Pulmonary cavitation and massive hemoptysis caused by an unsuspected intraparenchymal foreign body

A patient presented with massive hemoptysis, and a chest roentgenogram revealed a right lower lobe cavity which contained a movable mass of soft tissue density. He had sustained a gunshot wound to the chest seven years earlier. Thoracotomy was performed for uncontrollable hemoptysis, and parenchymal cavitation was found which contained a plastic foreign body. We retrieved a film following the original injury which revealed a mass density that proved to be a plastic wadding capsule from a shotgun shell. This type of complication from intraparenchymal foreign bodies is discussed and the unusual roentgenographic presentation of this patient is considered.