A true coin lesion.

This article is also accessible online at: http://BioMedNet.com/karger A 48-year-old man presented with a history of productive cough for some months. Clinically, pneumonia of the right lower lobe (RLL) was diagnosed. The PA chest roentgenogram (fig. 1) showed a ‘coin lesion’ of metal density at the right cardiac border, which presented as a disk on the lateral view (fig. 2). The RLL pneumonia was confirmed. Flexible bronchoscopy under local anesthesia revealed a coin trapped in the intermediate bronchus (fig. 3) which was successfully removed with a forceps and was identified as a Swiss 50 cents coin (diameter 1.8 cm/weight 2 g) (fig. 4). The postobstructive pneumonia and all symptoms resolved; the patient could not recollect having aspirated the coin. Originally, round lesions in the lung were often called coin lesions, today the more adequate term ‘solitary pulmonary nodule’ is used. Our case, however, illustrates a true coin lesion. 1