CTICasesDiaphragmatic elevation from massive liver metastases
Imaging findings
Serial chest radiographs and CT show a new, focal bulge and elevation of the right hemidiaphragm, which is demonstrated on CT to be caused by massive enlargement and lobulated metastases of the liver from a retroperitoneal sarcoma, rather than diaphragmatic paralysis.
Key takeaways
Focal diaphragmatic elevation can be caused by mass effect from subdiaphragmatic pathology, such as hepatomegaly or large hepatic metastases. Serial radiographs showing a newly acquired bulging appearance help differentiate this from congenital eventration or chronic paralysis.
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