Thoracic Manifestations of
|
|
- Shauna Grant
- 6 years ago
- Views:
Transcription
1 Cardiopulmonary Imaging Pictorial Essay etancourt et al. Inflammatory owel Disease Cardiopulmonary Imaging Pictorial Essay Downloaded from by on 02/06/18 from IP address Copyright RRS. For personal use only; all rights reserved Sonia L. etancourt 1 Diana Palacio 1 Carlos. Jimenez 2 Santiago Martinez 3 Edith M. Marom 1 etancourt SL, Palacio D, Jimenez C, Martinez S, Marom EM Keywords: airway disease, inflammatory bowel disease, parenchymal lung disease, pulmonary vascular disease, serositis DOI: /JR Received July 14, 2010; accepted after revision January 17, Department of Diagnostic Radiology, The University of Texas M. D. nderson Cancer Center, 1515 Holcombe lvd, Houston, TX ddress correspondence to S. L. etancourt (slbetancourt@mdanderson.org). 2 Department of Pulmonary Medicine, The University of Texas M. D. nderson Cancer Center, Houston, TX. 3 Department of Radiology, Duke University Medical Center, Durham, NC. WE This is a Web exclusive article. JR 2011; 197:W452 W X/11/1973 W452 merican Roentgen Ray Society Thoracic Manifestations of Inflammatory owel Disease OJECTIVE. The purpose of this article is to present the spectrum of inflammatory bowel disease manifestations in the chest, including the airways, lung parenchyma, pulmonary vasculature, and serosal surfaces. CONCLUSION. The spectrum of inflammatory bowel disease manifestations in the chest is broad, and the manifestations may mimic other diseases. Knowledge of these manifestations in conjunction with pertinent clinical data is essential for establishing the correct diagnosis and treatment. O ver the past few decades, the incidence of inflammatory bowel disease (ID) has risen in industrialized countries [1]. ID, namely Crohn disease and ulcerative colitis, has a variety of thoracic manifestations. Clinically encountered acute respiratory symptoms in patients with ID are most commonly due to infection. It is thought that significant respiratory symptoms from ID pulmonary involvement are rare [1, 2]. However, such patients may in fact be underdiagnosed because respiratory involvement may precede presentation of bowel disease by months or years [3], and respiratory symptoms have even been described after total colectomy [4]. In a randomly selected group of 44 ID patients, up to 48% had nonspecific respiratory symptoms, such as cough, shortness of breath, and wheezing, not attributable to infection [5]. Pulmonary function tests are suboptimal in patients with ID in comparison with healthy control subjects and do not always correlate with ID activity [5 7]. Finally, many patients who exhibit respiratory manifestations also exhibit other extraintestinal manifestations (e.g., arthritis, uveitis), suggesting a common pathophysiologic mechanism [8]. The pathogenesis of respiratory involvement in patients with ID may be related to the shared embryonic origin of the respiratory and intestinal systems, both of which originate from the primitive foregut and are formed by columnar epithelium containing goblet cells, which secrete mucus. In theory, intestinal and respiratory abnormalities ID patients could result from epithelial exposure to common antigens by inhalation and ingestion, leading to sensitization of the lymphoid tissue and inflammation. nother theory is that respiratory involvement in ID is due to inflammatory mediators released by the bowel mucosa [4, 6]. normal chest radiograph is seen in most symptomatic and asymptomatic ID patients with thoracic involvement [2, 9]. High-resolution CT is more sensitive in showing pulmonary abnormalities and has shown an abnormality in 19 of 36 (53%) symptomatic and asymptomatic patients in one study [10]. Respiratory manifestations may involve the large and small airways, pulmonary vasculature, lung parenchyma, or serosal surface [6]. In contrast to other extraintestinal manifestations, pulmonary parenchymal ID is seen more commonly with ulcerative colitis than Crohn disease, and large airway disease is strongly associated with ulcerative colitis [2, 3, 10]. pproximately 22% of ID patients with symptomatic respiratory involvement will show bronchiectasis; 20%, chronic bronchitis; 18%, interstitial lung disease; 12%, cryptogenic organizing pneumonia (COP); and 6%, necrobiotic nodules [2]. It is important to recognize these manifestations because they may mimic other diseases, leading to incorrect treatment. For example, airway involvement by ID should not be confused with typical or atypical infection. Lung parenchymal masslike lesions due to necrobiotic nodules in ID patients should not be confused with fungal infection, malignancy, or Wegener granulomatosis. In such W452 JR:197, September 2011
2 Inflammatory owel Disease Downloaded from by on 02/06/18 from IP address Copyright RRS. For personal use only; all rights reserved cases, histologic confirmation is required to provide adequate treatment. Finally, respiratory abnormalities may be related to drugs taken for treatment of ID, and these effects may resolve after discontinuation of ID-specific medications [11]. However, in cases with persistent pulmonary abnormalities after the withdrawal of medication, a biopsy should be performed. Parenchymal, serosal, and airway disease often respond well to steroids. Thus, knowledge of the spectrum of ID-related respiratory symptoms combined with a strong clinical suspicion will lead to early diagnosis. irway Disease irway inflammation is the most common form of respiratory involvement in ID patients, predominantly affecting the intermediate-sized central bronchi [6]. ronchiectasis is seen in 66% of airway involvement, and the remainder manifest as chronic bronchitis, suppurative large airway disease without airway dilation, or acute bronchitis [6]. Chest radiographs may show increased interstitial markings or a tramline pattern or may appear normal [12]. CT findings include diffuse concentric bronchial wall thickening with or without mucoid impaction and bronchiectasis cylindric, varicose, or cystic [12, 13] (Fig. 1). Small airway involvement is rarely encountered clinically [6]. Chest radiographs are usually normal or may show ill-defined reticulonodular or ground-glass opacities, poorly marginated pulmonary vessels, and/or large lung volumes because of air trapping. CT shows bronchiolar wall thickening, mucoid impaction, centrilobular ground-glass nodules, and mosaic attenuation because of air trapping (Fig. 2). Upper airway involvement, particularly tracheal involvement in the form of subglottic stenosis or diffuse tracheitis, is rare. Patients may present with hoarseness or stridor. The mucosa may exhibit a cobblestone appearance similar to that seen in affected intestines [14]. Chest radiographs and CT may show narrowing of any portion of the trachea, with circumferential tracheal wall thickening on CT (Fig. 3). Parenchymal Lung Disease Parenchymal lung disease is most commonly due to infection because ID-related parenchymal disease is rare. When present, it is usually due to COP. lthough COP may accompany pulmonary infection or occur as a manifestation of drug toxicity (Fig. 4), cases have been attributed to ID itself [6, 8]. Chest radiographs show focal to diffuse peripheral predominant airspace opacities. CT shows scattered, nonsegmental, unilateral, or bilateral foci of consolidation, ill-defined centrilobular nodules, and large irregular nodules (Fig. 5). Other forms of parenchymal disease that may be related to ID or drug toxicity are eosinophilic pneumonia and nonspecific interstitial pneumonitis. On CT, peripheral consolidation predominates in cases of eosinophilic pneumonia, whereas nonspecific interstitial pneumonitis shows ground-glass opacities, interlobular septal thickening, and irregular linear opacities [3, 15] (Figs. 6 and 7) Pulmonary necrobiotic nodules, histologically similar to those encountered in patients with rheumatoid arthritis, have also been seen in patients with ID and should be differentiated from malignancy and infection. On imaging, these nodules are round and well defined; they can measure up to a few centimeters in diameter and may cavitate. n infectious origin should be excluded because necrobiotic nodules will respond to steroids but not to antibiotics [3]. Several entities may coexist with ID and be linked to the disease. n example is sarcoidosis and ID [6, 8]. Genetic susceptibility and cellular immunity impairment are theoretically common mechanisms involved in the pathogenesis of both sarcoidosis and ID (Fig. 8), and they share similar dermatologic, ocular, and joint manifestations [2, 6]. lpha-1 antitrypsin deficiency has increased prevalence in patients with ID, although evidence does not show a direct link [6, 8] Serositis Serositis is not associated with ID activity. Pleural effusion is usually unilateral and exudative in nature (Fig. 9). When the pericardium is involved, it is usually not accompanied by pleural effusions [6]. Pulmonary Vascular Disease The incidence of thromboembolic events in ID patients is three to four times higher than in age-matched control subjects. Up to one third of thromboembolic events in this population occur while ID is quiescent, suggesting an unknown risk factor that is unrelated to treatment or disease activity [6] (Fig. 10). Conclusion With the increased use of CT, respiratory manifestations of ID are more commonly encountered. The spectrum of pulmonary involvement is wide, but correct identification of the disease pattern on imaging studies will allow clinicians to administer adequate treatment and avoid destructive irreversible airway changes or pulmonary fibrosis. References 1. Loftus EV Jr. Clinical epidemiology of inflammatory bowel disease: incidence, prevalence, and environmental influences. Gastroenterology 2004; 126: Hoffmann RM, Kruis W. Rare extraintestinal manifestations of inflammatory bowel disease. Inflamm owel Dis 2004; 10: Camus P, Colby TV. The lung in inflammatory bowel disease. Eur Respir J 2000; 15: Spira, Grossman R, alter M. Large airway disease associated with inflammatory bowel disease. Chest 1998; 113: Douglas JG, McDonald CF, Leslie MJ, Gillon J, Crompton GK, McHardy GJ. Respiratory impairment in inflammatory bowel disease: does it vary with disease activity? Respir Med 1989; 83: lack H, Mendoza M, Murin S. Thoracic manifestations of inflammatory bowel disease. Chest 2007; 131: Kuzela L, Vavrecka, Prikazska M, et al. Pulmonary complications in patients with inflammatory bowel disease. Hepatogastroenterology 1999; 46: Storch I, Sachar D, Katz S. Pulmonary manifestations of inflammatory bowel disease. Inflamm owel Dis 2003; 9: Raj, irring SS, Green R, Grant, de Caestecker J, Pavord ID. Prevalence of inflammatory bowel disease in patients with airways disease. Respir Med 2008; 102: Songür N, Songür Y, Tüzün M, et al. Pulmonary function tests and high-resolution CT in the detection of pulmonary involvement in inflammatory bowel disease. J Clin Gastroenterol 2003; 37: Salerno SM, Ormseth EJ, Roth J, Meyer C, Christensen ED, Dillard T. Sulfasalazine pulmonary toxicity in ulcerative colitis mimicking clinical features of Wegener s granulomatosis. Chest 1996; 110: Camus P, Piard F, shcroft T, Gal, Colby TV. The lung in inflammatory bowel disease. Medicine (altimore) 1993; 72: Garg K, Lynch D, Newell JD. Inflammatory airways disease in ulcerative colitis: CT and highresolution CT features. J Thorac Imaging 1993; 8: Janssen WJ, ierig LN, euther D, Miller YE. Stridor in a 47-year-old man with inflammatory bowel disease. Chest 2006; 129: Katzenstein L, Myers JL. Idiopathic pulmonary fibrosis: clinical relevance of pathologic classification. m J Respir Crit Care Med 1998; 157: JR:197, September 2011 W453
3 etancourt et al. Downloaded from by on 02/06/18 from IP address Copyright RRS. For personal use only; all rights reserved Fig year-old woman with cough and active ulcerative colitis. Contrast-enhanced chest CT scan at level of main bronchi shows diffuse bronchiectasis of intermediate airways. Fig year-old man with ulcerative colitis and nonspecific respiratory symptoms. and, Unenhanced inspiratory chest CT scan () shows subtle bilateral centrilobular nodules (arrows) and mosaic attenuation consistent with small airways disease. ir trapping is evident on expiratory view (). fter antibiotics were administered for 2 weeks but failed to resolve symptoms, steroidal therapy was initiated and resulted in dramatic clinical and radiographic response (not shown). Fig year-old woman with Crohn disease who presented with stridor. (Courtesy of oiselle P, Harvard Medical School, eth Israel Deaconess Medical Center, oston, M), Unenhanced, volume-rendered chest CT scan shows focal area of subglottic stenosis (arrows)., Corresponding axial CT scan at level of stenosis shows asymmetric tracheal wall thickening (arrow). Fig year-old man with active ulcerative colitis treated with mesalamine. (Courtesy of Restrepo C, The University of Texas Health Science Center at San ntonio, San ntonio, TX), Frontal chest radiograph shows bilateral peripheral opacities (arrows)., Contrast-enhanced chest CT scan shows that opacities seen on chest radiograph are peripheral lenticular-shaped areas of consolidation. iopsy (not shown) revealed findings consistent with cryptogenic organizing pneumonia. Remission was achieved after discontinuation of mesalamine (antiinflammatory agent), confirming diagnosis of mesalamine-induced organizing pneumonia. W454 JR:197, September 2011
4 Inflammatory owel Disease Downloaded from by on 02/06/18 from IP address Copyright RRS. For personal use only; all rights reserved Fig year-old woman with ulcerative colitis who was hospitalized with cough, fever, and dyspnea. xial CT scan of chest shows scattered ground-glass opacities and intralobular septal thickening with little traction bronchiectasis. iopsy (not shown) was consistent with nonspecific interstitial pneumonia. Fig year-old man with Crohn disease., Unenhanced chest CT scan shows bilateral pulmonary nodules, some of which show groundglass opacity, surrounded by ring of soft tissue (arrows) that appears as reverse halo sign, which was initially described in cases of cryptogenic organizing pneumonia (COP) but is also seen with other entities, such as infection and vasculitis., Photomicrograph of biopsy specimen from larger nodule reveals severe peribronchiolar cellular infiltration and granulation tissue in alveolar ducts and adjacent airspaces, consistent with COP associated with inflammatory bowel disease (arrows). (H and E, 40) Fig year-old woman with active ulcerative colitis., Frontal chest radiograph shows bilateral peripheral heterogeneous airspace opacities., Contrast-enhanced CT scan shows scattered peripheral predominant airspace disease. Transbronchial biopsy (not shown) revealed filling of alveoli with eosinophils and macrophages with foci of organizing pneumonia, consistent with eosinophilic pneumonia. JR:197, September 2011 W455
5 etancourt et al. Downloaded from by on 02/06/18 from IP address Copyright RRS. For personal use only; all rights reserved Fig year-old woman with Crohn disease., Frontal chest radiograph shows symmetric bilateral mediastinal and hilar adenopathy. and C, Contrast-enhanced chest CT scans confirm mediastinal and hilar adenopathy. Endobronchial biopsy (not shown) revealed noncaseating granulomas with negative fungal serologies and cultures, consistent with sarcoidosis. Fig year-old afebrile man with ulcerative colitis and no additional comorbidities who presented with mild shortness of breath. Coronal reformation of contrast-enhanced chest CT image reveals left pleural effusion, no infection, and no pulmonary embolus. Effusion spontaneously resolved on routine follow-up chest radiographs (not shown). Fig year-old man with active Crohn disease and acute shortness of breath. and, xial () and sagittal reformation () contrast-enhanced chest CT scans show low-attenuation filling defect in segmental right lower lobe pulmonary artery (arrow) consistent with pulmonary embolus. There is peripheral wedge-shaped consolidation (asterisk, ), compatible with pulmonary infarct. Small pleural effusions are also present (arrowheads, ). C W456 JR:197, September 2011
An Image Repository for Chest CT
An Image Repository for Chest CT Francesco Frajoli for the Chest CT in Antibody Deficiency Group An Image Repository for Chest CT he Chest CT in Antibody Deficiency Group is an international and interdisciplinary
More informationAcute and Chronic Lung Disease
KATHOLIEKE UNIVERSITEIT LEUVEN Faculty of Medicine Acute and Chronic Lung Disease W De Wever, JA Verschakelen Department of Radiology, University Hospitals Leuven, Belgium Clinical utility of HRCT To detect
More informationDownloaded from by on 01/23/18 from IP address Copyright ARRS. For personal use only; all rights reserved
Downloaded from www.ajronline.org by 46.3.194.46 on 01/23/18 from IP address 46.3.194.46. Copyright RRS. For personal use only; all rights reserved sthma is an inflammatory disease of the lungs characterized
More informationCryptogenic Organizing Pneumonia Diagnosis Approach Based on a Clinical-Radiologic-Pathologic Consensus
Cryptogenic Organizing Pneumonia Diagnosis Approach Based on a Clinical-Radiologic-Pathologic Consensus Poster No.: C-1622 Congress: ECR 2012 Type: Scientific Exhibit Authors: C. Cordero Lares, E. Zorita
More informationSystemic lupus erythematosus (SLE): Pleuropulmonary Manifestations
08/30/10 09/26/10 Systemic lupus erythematosus (SLE): Pleuropulmonary Manifestations Camila Downey S. Universidad de Chile, School of Medicine, Year VII Harvard University, School of Medicine Sept 17,
More informationHypersensitivity Pneumonitis: Spectrum of High-Resolution CT and Pathologic Findings
CT of Hypersensitivity Pneumonitis Chest Imaging Pictorial Essay C. Isabela S. Silva 1 ndrew Churg 2 Nestor L. Müller 1 Silva CIS, Churg, Müller NL Keywords: high-resolution CT, hypersensitivity pneumonitis,
More informationDifferential diagnosis
Differential diagnosis Idiopathic pulmonary fibrosis (IPF) is part of a large family of idiopathic interstitial pneumonias (IIP), one of four subgroups of interstitial lung disease (ILD). Differential
More informationOctober 2012 Imaging Case of the Month. Michael B. Gotway, MD Associate Editor Imaging. Department of Radiology Mayo Clinic Arizona Scottsdale, AZ
October 2012 Imaging Case of the Month Michael B. Gotway, MD Associate Editor Imaging Department of Radiology Mayo Clinic Arizona Scottsdale, AZ Clinical History: A 65-year-old non-smoking woman presented
More information11/10/2014. Multi-disciplinary Approach to Diffuse Lung Disease: The Imager s Perspective. Radiology
Multi-disciplinary Approach to Diffuse Lung Disease: The Imager s Perspective Radiology Pathology Clinical 1 Role of HRCT Diagnosis Fibrosis vs. inflammation Next step in management Response to treatment
More informationNONE OVERVIEW FINANCIAL DISCLOSURES UPDATE ON IDIOPATHIC PULMONARY FIBROSIS/IPF (UIP) FOR PATHOLOGISTS. IPF = Idiopathic UIP Radiologic UIP Path UIP
UPDATE ON IDIOPATHIC PULMONARY FIBROSIS/IPF () FOR PATHOLOGISTS Thomas V. Colby, M.D. Professor of Pathology (Emeritus) Mayo Clinic Arizona FINANCIAL DISCLOSURES NONE OVERVIEW IPF Radiologic Dx Pathologic
More informationLung Allograft Dysfunction
Lung Allograft Dysfunction Carlos S. Restrepo M.D. Ameya Baxi M.D. Department of Radiology University of Texas Health San Antonio Disclaimer: We do not have any conflict of interest or financial gain to
More informationHYPERSENSITIVITY PNEUMONITIS
HYPERSENSITIVITY PNEUMONITIS A preventable fibrosis MOSAVIR ANSARIE MB., FCCP INTERSTITIAL LUNG DISEASES A heterogeneous group of non infectious, non malignant diffuse parenchymal disorders of the lower
More informationImaging Small Airways Diseases: Not Just Air trapping. Eric J. Stern MD University of Washington
Imaging Small Airways Diseases: Not Just Air trapping Eric J. Stern MD University of Washington What we are discussing SAD classification SAD imaging with MDCT emphasis What is a small airway? Airway with
More informationBronchiectasis: An Imaging Approach
Bronchiectasis: An Imaging Approach Travis S Henry, MD Associate Professor of Clinical Radiology Cardiac and Pulmonary Imaging Section University of California, San Francisco Large Middle Small 1 Bronchiectasis
More informationThoracic lung involvement in rheumatoid arthritis: Findings on HRCT
Thoracic lung involvement in rheumatoid arthritis: Findings on HRCT Poster No.: C-2488 Congress: ECR 2015 Type: Educational Exhibit Authors: R. E. Correa Soto, M. J. Martín Sánchez, J. M. Fernandez 1 1
More informationPulmonary Sarcoidosis - Radiological Evaluation
Original Research Article Pulmonary Sarcoidosis - Radiological Evaluation Jayesh Shah 1, Darshan Shah 2*, C. Raychaudhuri 3 1 Associate Professor, 2 1 st Year Resident, 3 Professor and HOD Radiology Department,
More informationUsual Interstitial pneumonia and Nonspecific Interstitial Pneumonia. Nitra and the Gangs.
Usual Interstitial pneumonia and Nonspecific Interstitial Pneumonia Nitra and the Gangs. บทน ำและบทท ๓, ๑๐, ๑๒, ๑๓, ๑๔, ๑๕, ๑๗ Usual Interstitial Pneumonia (UIP) Most common & basic pathologic pattern
More informationAn Introduction to Radiology for TB Nurses
An Introduction to Radiology for TB Nurses Garold O. Minns, MD September 14, 2017 TB Nurse Case Management September 12 14, 2017 EXCELLENCE EXPERTISE INNOVATION Garold O. Minns, MD has the following disclosures
More informationPictorial Essay. Diffuse Abnormalities of the Trachea and Main Bronchi. Edith M. Marom 1, Philip C. Goodman, H. Page McAdams
Downloaded from www.ajronline.org by 37.44.196.13 on 12/09/17 from IP address 37.44.196.13. opyright RRS. For personal use only; all rights reserved Diffuse bnormalities of the Trachea and Main ronchi
More informationHRCT in Diffuse Interstitial Lung Disease Steps in High Resolution CT Diagnosis. Where are the lymphatics? Anatomic distribution
Steps in High Resolution CT Diagnosis Pattern of abnormality Distribution of disease Associated findings Clinical history Tomás Franquet MD What is the diagnosis? Hospital de Sant Pau. Barcelona Secondary
More informationACUTE PULMNARY INFECTIONS: UNDERSTANDING THE CHEST RADIOGRAPH. Leonard E. Swischuk, M.D. University of Texas Medical Branch
ACUTE PULMNARY INFECTIONS: UNDERSTANDING THE CHEST RADIOGRAPH Leonard E. Swischuk, M.D. University of Texas Medical Branch AUTHOR HAS NOTHING TO DECLARE LEARNING OBJETIVES Understand the pathophysiology
More informationFinancial disclosure COMMON DIAGNOSES IN HRCT. High Res Chest HRCT. HRCT Pre test. I have no financial relationships to disclose. Anatomy Nomenclature
Financial disclosure I have no financial relationships to disclose. Douglas Johnson D.O. Cardiothoracic Imaging Gaston Radiology COMMON DIAGNOSES IN HRCT High Res Chest Anatomy Nomenclature HRCT Sampling
More informationINTERSTITIAL LUNG DISEASE. Radhika Reddy MD Pulmonary/Critical Care Long Beach VA Medical Center January 5, 2018
INTERSTITIAL LUNG DISEASE Radhika Reddy MD Pulmonary/Critical Care Long Beach VA Medical Center January 5, 2018 Interstitial Lung Disease Interstitial Lung Disease Prevalence by Diagnosis: Idiopathic Interstitial
More informationLiebow and Carrington's original classification of IIP
Liebow and Carrington's original classification of IIP-- 1969 Eric J. Stern MD University of Washington UIP Usual interstitial pneumonia DIP Desquamative interstitial pneumonia BIP Bronchiolitis obliterans
More informationAtopic Pulmonary Disease: Findings on Thoracic Imaging
July 2003 Atopic Pulmonary Disease: Findings on Thoracic Imaging Rebecca G. Breslow Harvard Medical School Year IV Churg-Strauss Syndrome Hypersensitivity Pneumonitis Asthma Atopic Pulmonary Disease Allergic
More informationPULMONARY TUBERCULOSIS RADIOLOGY
PULMONARY TUBERCULOSIS RADIOLOGY RADIOLOGICAL MODALITIES Medical radiophotography Radiography Fluoroscopy Linear (conventional) tomography Computed tomography Pulmonary angiography, bronchography Ultrasonography,
More informationOutline Definition of Terms: Lexicon. Traction Bronchiectasis
HRCT OF IDIOPATHIC INTERSTITIAL PNEUMONIAS Disclosures Genentech, Inc. Speakers Bureau Tadashi Allen, MD University of Minnesota Assistant Professor Diagnostic Radiology 10/29/2016 Outline Definition of
More informationTB Radiology for Nurses Garold O. Minns, MD
TB Nurse Case Management Salina, Kansas March 31-April 1, 2010 TB Radiology for Nurses Garold O. Minns, MD April 1, 2010 TB Radiology for Nurses Highway Patrol Training Center Salina, KS April 1, 2010
More informationARDS - a must know. Page 1 of 14
ARDS - a must know Poster No.: C-1683 Congress: ECR 2016 Type: Authors: Keywords: DOI: Educational Exhibit M. Cristian; Turda/RO Education and training, Edema, Acute, Localisation, Education, Digital radiography,
More informationBronkhorst colloquium Interstitiële longziekten. Katrien Grünberg, klinisch patholoog
Bronkhorst colloquium 2013-2014 Interstitiële longziekten De pathologie achter de CT Katrien Grünberg, klinisch patholoog K.grunberg@vumc.nl Preparing: introduction and 3 cases The introduction on microscopic
More informationRadiologic Approach to Smoking Related Interstitial Lung Disease
Radiologic Approach to Smoking Related Interstitial Lung Disease Poster No.: C-1854 Congress: ECR 2013 Type: Educational Exhibit Authors: K.-N. Lee, J.-Y. Han, E.-J. Kang, J. Kang; Busan/KR Keywords: Toxicity,
More informationCT of Diffuse Tracheal Diseases
Residents Section Structured Review rticle hung et al. T of the Trachea and entral irways Residents Section Structured Review rticle Downloaded from www.ajronline.org by 46.3.202.185 on 02/15/18 from IP
More information10/17/2016. Nuts and Bolts of Thoracic Radiology. Objectives. Techniques
Nuts and Bolts of Thoracic Radiology October 20, 2016 Carleen Risaliti Objectives Understand the basics of chest radiograph Develop a system for interpreting chest radiographs Correctly identify thoracic
More informationWhen to suspect Wegener Granulomatosis: A radiologic review
When to suspect Wegener Granulomatosis: A radiologic review Poster No.: P-0038 Congress: ESTI 2015 Type: Educational Poster Authors: A. Tilve Gómez, R. Díez Bandera, P. Rodríguez Fernández, M. Garcia Vazquez-Noguerol,
More informationThe Imaging Analysis of Pulmonary Sarcodiosis
www.cancercellresearch.org ISSN: 2161-2609 Article The Imaging Analysis of Pulmonary Sarcodiosis Xin He, Chuanyu Zhang* Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, China
More informationManish Powari Regional Training Day 10/12/2014
Manish Powari Regional Training Day 10/12/2014 Large number of different types of Interstitial Lung Disease (ILD). Most are very rare Most patients present with one of a smaller number of commoner diseases
More informationSESSION IV: MECHANISMS OF HUMAN DISEASE: LABORATORY SESSIONS PULMONARY PATHOLOGY I. December 5, 2012
SESSION IV: MECHANISMS OF HUMAN DISEASE: LABORATORY SESSIONS PULMONARY PATHOLOGY I December 5, 2012 FACULTY COPY GOAL: Describe the basic morphologic and pathophysiologic changes in various conditions
More informationAugust 2018 Imaging Case of the Month: Dyspnea in a 55-Year-Old Smoker. Michael B. Gotway, MD
August 2018 Imaging Case of the Month: Dyspnea in a 55-Year-Old Smoker Michael B. Gotway, MD Department of Radiology Mayo Clinic Arizona Scottsdale, AZ USA Clinical History: A 55 year old woman presented
More informationVascular Lung Diseases
Vascular Lung Diseases SESSION SPECIFIC OBJECTIVES List the major types of vascular lung disease Recognize and describe the pathology of vascular lung disease: Pulmonary embolism, thrombosis, hypertension,
More informationDiagnosis of TB: Radiology David Finlay, MD
TB Intensive Tyler, Texas June 2-4, 2010 Diagnosis of TB: Radiology David Finlay, MD June 3, 2010 2stages stages- Tuberculosis 1. primary infection 2. reactivation, or post primary disease 2 1 Primary
More informationCT Diagnosis of Pulmonary Wegener s Granulomatosis: A Case Report and Review of Literature
CASE REPORT JIACM 2008; 9(4): 321-5 CT Diagnosis of Pulmonary Wegener s Granulomatosis: A Case Report and Review of Literature Shibani Mehra*, Shailendra Aggarwal Abstract The diagnosis of Wegener s granulomatosis
More informationCase 1: Question. 1.1 What is the main pattern of this HRCT? 1. Intralobular line 2. Groundglass opacity 3. Perilymphatic nodule
HRCT WORK SHOP Case 1 Case 1: Question 1.1 What is the main pattern of this HRCT? 1. Intralobular line 2. Groundglass opacity 3. Perilymphatic nodule Case 1: Question 1.2 What is the diagnosis? 1. Hypersensitivity
More informationCase 1 : Question. 1.1 What is the intralobular distribution? 1. Centrilobular 2. Perilymphatic 3. Random
Interesting case Case 1 Case 1 : Question 1.1 What is the intralobular distribution? 1. Centrilobular 2. Perilymphatic 3. Random Case 1: Answer 1.1 What is the intralobular distribution? 1. Centrilobular
More informationDaria Manos RSNA 2016 RC 401. https://medicine.dal.ca/departments/depar tment-sites/radiology/contact/faculty/dariamanos.html
Daria Manos RSNA 2016 RC 401 https://medicine.dal.ca/departments/depar tment-sites/radiology/contact/faculty/dariamanos.html STEP1: Is this fibrotic lung disease? STEP 2: Is this a UIP pattern? If yes:
More informationPulmonary Manifestations of Systemic Lupus Erythematosus 1
Pulmonary Manifestations of Systemic Lupus Erythematosus 1 Kee Hyuk Yang, M.D., Yo Won Choi, M.D., Seok Chol Jeon, M.D., Choong Ki Park, M.D., Kyung in Joo, M.D., Chang Kok Hahm, M.D., Seung Ro Lee, M.D.
More informationSeptember 2014 Imaging Case of the Month. Michael B. Gotway, MD. Department of Radiology Mayo Clinic Arizona Scottsdale, AZ
September 2014 Imaging Case of the Month Michael B. Gotway, MD Department of Radiology Mayo Clinic Arizona Scottsdale, AZ Clinical History: A 57-year-old non-smoking woman presented to her physician as
More informationThoracic Sarcoidosis Imaging Updated: Jul 19, 2013
Thoracic Sarcoidosis Imaging Updated: Jul 19, 2013 Overview Radiography Computed Tomography Magnetic Resonance Imaging Nuclear Imaging Show All Multimedia Library References Overview For patients with
More informationSilicoproteinosis: High-Resolution CT Findings in 13 Patients
CT of Silicoproteinosis Chest Imaging Clinical Observations Edson Marchiori 1 Carolina lthoff Souza 2 Tatiana Gontijo arbassa 1 Dante L. Escuissato 3 Emerson L. Gasparetto 1 rthur Soares Souza, Jr. 4 Marchiori
More informationThoracic sarcoidosis: Pictoral review of typical and atypical findings
Thoracic sarcoidosis: Pictoral review of typical and atypical findings Poster No.: C-0804 Congress: ECR 2010 Type: Educational Exhibit Topic: Chest Authors: A. Ferreira, J. Calha; Lisbon/PT Keywords: Sarcoidosis,
More informationARTICLE IN PRESS. Ahuva Grubstein a, Daniele Bendayan b, Ithak Schactman c, Maya Cohen a, David Shitrit b, Mordechai R. Kramer b,
Respiratory Medicine (2005) 99, 948 954 Concomitant upper-lobe bullous emphysema, lower-lobe interstitial fibrosis and pulmonary hypertension in heavy smokers: report of eight cases and review of the literature
More informationPULMONARY MEDICINE BOARD REVIEW. Financial Conflicts of Interest. Question #1: Question #1 (Cont.): None. Christopher H. Fanta, M.D.
PULMONARY MEDICINE BOARD REVIEW Christopher H. Fanta, M.D. Pulmonary and Critical Care Division Brigham and Women s Hospital Partners Asthma Center Harvard Medical School Financial Conflicts of Interest
More informationThe Reversed Halo Sign on High- Resolution CT in Infectious and Noninfectious Pulmonary Diseases
Cardiopulmonary Imaging Pictorial Essay Marchiori et al. Reversed Halo Sign on HRCT Cardiopulmonary Imaging Pictorial Essay Downloaded from www.ajronline.org by 148.251.232.83 on 04/01/18 from IP address
More informationChest Radiology Interpretation: Findings of Tuberculosis
Chest Radiology Interpretation: Findings of Tuberculosis Get out your laptops, smart phones or other devices pollev.com/chestradiology Case #1 1 Plombage Pneumonia Cancer 2 Reading the TB CXR Be systematic!
More informationInteresting Cases. Pulmonary
Interesting Cases Pulmonary 54M with prior history of COPD, hep B/C, and possible history of TB presented with acute on chronic dyspnea, and productive cough Hazy opacity overlying the left hemithorax
More informationT he diagnostic evaluation of a patient with
546 REVIEW SERIES Challenges in pulmonary fibrosis? 1: Use of high resolution CT scanning of the lung for the evaluation of patients with idiopathic interstitial pneumonias Michael B Gotway, Michelle M
More informationA Review of Interstitial Lung Diseases
Outline A Review of Interstitial Lung Diseases Paul J. Wolters, MD Associate Professor Department of Medicine University of California San Francisco Overview of diagnosis in ILD Why it is important Definition/Classification
More informationA Review of Interstitial Lung Diseases. Paul J. Wolters, MD Associate Professor Department of Medicine University of California San Francisco
A Review of Interstitial Lung Diseases Paul J. Wolters, MD Associate Professor Department of Medicine University of California San Francisco Outline Overview of diagnosis in ILD Why it is important Definition/Classification
More informationTB Intensive San Antonio, Texas November 29-December 2, 2011
TB Intensive San Antonio, Texas November 29-December 2, 2011 Diagnosis of TB: Radiology Michael McCarthy, MD, FACR November 30, 2011 Michael McCarthy, MD, FACR has the following disclosures to make: No
More informationThe crazy-paving pattern: A radiological-pathological correlated and illustrated overview
The crazy-paving pattern: A radiological-pathological correlated and illustrated overview Poster No.: C-0827 Congress: ECR 2010 Type: Educational Exhibit Topic: Chest Authors: W. F. M. De Wever, J. Coolen,
More informationPulmonary CT Findings of Visceral Larva Migrans due to Ascaris suum
Pulmonary CT Findings of Visceral Larva Migrans due to Ascaris suum Poster No.: E-0038 Congress: ESTI 2012 Type: Scientific Exhibit Authors: K. Honda, F. Okada, Y. Ando, A. Ono, S. Matsumoto, H. Mori;
More informationTuberculosis: The Essentials
Tuberculosis: The Essentials Kendra L. Fisher, MD, PhD THORACIC TUBERCULOSIS: THE BARE ESSENTIALS Kendra Fisher MD, FRCP (C) Department of Radiology Loma Linda University Medical Center TUBERCULOSIS ()
More informationTB Intensive Houston, Texas
TB Intensive Houston, Texas October 15-17, 17 2013 Diagnosis of TB: Radiology Rosa M Estrada-Y-Martin, MD MSc FCCP October 16, 2013 Rosa M Estrada-Y-Martin, MD MSc FCCP, has the following disclosures to
More informationPediatric High-Resolution Chest CT
Pediatric High-Resolution Chest CT Alan S. Brody, MD Professor of Radiology and Pediatrics Chief, Thoracic Imaging Cincinnati Children s s Hospital Cincinnati, Ohio, USA Pediatric High-Resolution CT Short
More informationRadiological Imaging of Drug-Induced Pulmonary Lesions
Review Article imedpub Journals www.imedpub.com Journal of Clinical Radiology and Case Reports Radiological Imaging of Drug-Induced Pulmonary Lesions D souza M *, Rajiah P, Khan A and Irion K Department
More informationPneumocystis jiroveci Pneumonia: High-Resolution CT Findings in Patients With and Without HIV Infection
Cardiopulmonary Imaging Pictorial Essay Kanne et al. CT of Pneumocystis jiroveci Pneumonia Cardiopulmonary Imaging Pictorial Essay Jeffrey P. Kanne 1 Donald R. Yandow Cristopher. Meyer Kanne JP, Yandow
More information4/17/2010 C ini n ca c l a Ev E a v l a ua u t a ion o n of o ILD U dat a e t e i n I LDs
Update in ILDs Diagnosis 101: Clinical Evaluation April 17, 2010 Jay H. Ryu, MD Mayo Clinic, Rochester MN Clinical Evaluation of ILD Outline General aspects of ILDs Classification of ILDs Clinical evaluation
More informationDisease spectrum. IPA Invasive pulmonary aspergillosis
Aspergillus & ABPA Disease spectrum IPA Invasive pulmonary aspergillosis ABPA ABPA pathophysiology conidia of Aspergillus trapped in mucous and narrowed airways of asthmatics/cf germinate to form hyphae
More informationHow to Analyse Difficult Chest CT
How to Analyse Difficult Chest CT Complex diseases are:- - Large lesion - Unusual or atypical pattern - Multiple discordant findings Diffuse diseases are:- - Numerous findings in both sides 3 basic steps
More information5/9/2015. Multi-disciplinary Approach to Diffuse Lung Disease: The Imager s Perspective. No, I am not a pulmonologist! Radiology
Multi-disciplinary Approach to Diffuse Lung Disease: The Imager s Perspective No, I am not a pulmonologist! Radiology Pathology Clinical 1 Everyone needs a CT Confidence in diagnosis Definitive HRCT +
More informationand localized ground glass opacities, or bronchiolar focal or multifocal micronodules;
E1 Chest CT scan and Pneumoniae_YE Claessens et al- Supplementary methods Level of CAP probability according to CT scan - definite CAP: systematic alveolar condensation, or alveolar condensation with peripheral
More informationCase 4 History. 58 yo man presented with prox IP joint swelling 2 months later pain and swelling in multiple joints Chest radiograph: bi-basilar
Case 4 History 58 yo man presented with prox IP joint swelling 2 months later pain and swelling in multiple joints Chest radiograph: bi-basilar basilar infiltrates suggestive of pulmonary fibrosis Open
More informationHow to identify interstitial pneumonias.
How to identify interstitial pneumonias. Poster No.: C-0804 Congress: ECR 2014 Type: Educational Exhibit Authors: S. claret loaiza, M. C. Cañete Moslero, R. Carreño Gonzalez, C. de la Torre; Malaga/ES
More information4.6 Small airways disease
4.6 Small airways disease Author: Jean-Marc Fellrath 1. INTRODUCTION Small airways are defined as any non alveolated and noncartilaginous airway that has an internal diameter of 2 mm. Several observations
More information2009 H1N1 Influenza Infection: Spectrum Of Chest CT Findings, With Radiologic- Pathologic Correlation
ISPUB.COM The Internet Journal of Radiology Volume 12 Number 2 2009 H1N1 Influenza Infection: Spectrum Of Chest CT Findings, With Radiologic- Pathologic Correlation A Nachiappan, E Weihe, B Akkanti, V
More informationPulmonary manifestations of Rheumatoid Arthritis: what is there waiting to be found?
Pulmonary manifestations of Rheumatoid Arthritis: what is there waiting to be found? Poster No.: C-1795 Congress: ECR 2015 Type: Educational Exhibit Authors: M. S. C. Rodrigues, R. Correia, A. Carvalho,
More informationOriginal Report. Fibrosis of the Upper Lobes: A Newly Identified Late-Onset Complication After Lung Transplantation?
Downloaded from www.ajronline.org by 148.251.232.83 on 05/04/18 from IP address 148.251.232.83. opyright RRS. For personal use only; all rights reserved Eli Konen 1,2 Gordon L. Weisbrod 1 Smita Pakhale
More informationCT in Idiopathic Pulmonary Fibrosis: Diagnosis and Beyond
Cardiopulmonary Imaging Review Gruden CT of Idiopathic Pulmonary Fibrosis Cardiopulmonary Imaging Review James F. Gruden 1 Gruden JF FOCUS ON: Keywords: CT, diagnosis, high-resolution CT, idiopathic pulmonary
More informationBronchial syndrome. Atelectasis Draining bronchus Bronchiectasis
Bronchial syndrome Atelectasis Draining bronchus Bronchiectasis Etienne Leroy Terquem Pierre L Her SPI / ISP Soutien Pneumologique International / International Support for Pulmonology Atelectasis Consequence
More informationResidents Section Pattern of the Month
Residents Section Pattern of the Month Gosset et al. Tree-In-Bud Pattern Residents Section Pattern of the Month Residents inradiology Natacha Gosset 1 Alexander A. Bankier Ronald L. Eisenberg Gosset N,
More informationCriteria for confident HRCT diagnosis of usual interstitial pneumonia (UIP)
Criteria for confident HRCT diagnosis of usual interstitial pneumonia (UIP) Assem El Essawy (1) & Amr A. Nassef (٢) Abstract Identification of interstitial pneumonia (IP) was mainly based on histological
More informationSurgical indications: Non-malignant pulmonary diseases. Punnarerk Thongcharoen
Surgical indications: Non-malignant pulmonary diseases Punnarerk Thongcharoen Non-malignant Malignant as a pathological term: Cancer Non-malignant = not cancer Malignant as an adjective: Disposed to cause
More informationTypical and atypical findings of pulmonary sarcoidosis at high resolution CT
Typical and atypical findings of pulmonary sarcoidosis at high resolution CT Poster No.: C-0169 Congress: ECR 2013 Type: Educational Exhibit Authors: L. Raposo Rodríguez, C. Mejía, B. Escobar Mallada,
More informationFOREIGN BODY ASPIRATION in children. Dr. Xayyavong Bouathongthip, M.D Emergency department, children s hospital
FOREIGN BODY ASPIRATION in children Dr. Xayyavong Bouathongthip, M.D Emergency department, children s hospital How common is choking? About 3,000 people die/year from choking Figure remained unchanged
More informationRadiation Pneumonitis Joseph Junewick, MD FACR
Radiation Pneumonitis Joseph Junewick, MD FACR 03/19/2010 History 16 year old with history of relapsed stage IV-A Hodgkin disease. Prior pulmonary involvement was irradiated. Diagnosis Radiation Pneumonitis
More informationReplacement of air with fluid, inflammatory. cells or cellular debris. Parenchymal, Interstitial (Restrictive) and Vascular Diseases.
Parenchymal, Interstitial (Restrictive) and Vascular Diseases Alain C. Borczuk, M.D. Dept of Pathology Replacement of air with fluid, inflammatory cells Pulmonary Edema Pneumonia Hemorrhage Diffuse alveolar
More informationChronic Cough Due to Nonbronchiectatic Suppurative Airway Disease (Bronchiolitis) ACCP Evidence-Based Clinical Practice Guidelines
Chronic Cough Due to Nonbronchiectatic Suppurative Airway Disease (Bronchiolitis) ACCP Evidence-Based Clinical Practice Guidelines Kevin K. Brown, MD, FCCP Objectives: To review the role of nonbronchiectatic
More informationPulmonary manifestations of inflammatory bowel disease: Case presentations and review
Journal of Crohn's and Colitis (2010) 4, 390 397 available at www.sciencedirect.com Pulmonary manifestations of inflammatory bowel disease: Case presentations and review Benjamin Basseri a,pedramenayati
More informationDiseases of the Lung and Respiratory Tract, Part I. William Bligh-Glover M.D. Department of Anatomy, CWRU
Diseases of the Lung and Respiratory Tract, Part I William Bligh-Glover M.D. Department of Anatomy, CWRU Educational objectives: Distinguish the types of atelectasis and their etiologies Distinguish the
More informationTypical and Atypical Manifestations of Intrathoracic Sarcoidosis
Typical and typical Manifestations of Intrathoracic Sarcoidosis Hyun Jin Park, MD 1 Jung Im Jung, MD 1 Myung Hee Chung, MD 1 Sun Wha Song, MD 1 Hyo Lim Kim, MD 1 Jun Hyun aik, MD 1 Dae Hee Han, MD 1 Ki
More informationImaging: how to recognise idiopathic pulmonary fibrosis
REVIEW IDIOPATHIC PULMONARY FIBROSIS Imaging: how to recognise idiopathic pulmonary fibrosis Anand Devaraj Affiliations: Dept of Radiology, St George s Hospital, London, UK. Correspondence: Anand Devaraj,
More informationThin-Section CT Findings in 32 Immunocompromised Patients with Cytomegalovirus Pneumonia Who Do Not Have AIDS
Tomás Franquet 1,2 Kyung S. Lee 3 Nestor L. Müller 1 Received January 27, 2003; accepted after revision April 21, 2003. 1 Department of Radiology, Vancouver Hospital and Health Sciences Center and University
More informationRadiologic findings of drug-induced lung disease
Radiologic findings of drug-induced lung disease Poster No.: P-0115 Congress: ESTI 2015 Type: Educational Poster Authors: A. I. C. Santos, A. F. Roque, R. Mamede, L. Oliveira, T. Saldanha; Lisbon/PT Keywords:
More informationCase of the Day Chest
Case of the Day Chest Darin White MDCM FRCPC Department of Radiology, Mayo Clinic 76 th Annual Scientific Meeting Canadian Association of Radiologists Montreal, QC April 26, 2013 2013 MFMER slide-1 Disclosures
More informationIPF: Epidemiologia e stato dell arte
IPF: Epidemiologia e stato dell arte Clinical Classification Diffuse parenchimal lung diseases Exposure-related: - occupational - environmental - medication Desquamative interstitial pneumonia Idiopathic
More informationRecurrent Ovarian Cancer: Spectrum of Imaging Findings
Recurrent Ovarian Cancer Women s Imaging Pictorial Essay Downloaded from www.ajronline.org by 80.243.130.157 on 03/08/18 from IP address 80.243.130.157. Copyright RRS. For personal use only; all rights
More informationPneumocystis jirovecci pneumonia: from mild disease to a real disaster. A pictorial review of the different radiologic patterns in acute settings
Pneumocystis jirovecci pneumonia: from mild disease to a real disaster. A pictorial review of the different radiologic patterns in acute settings Poster No.: C-1425 Congress: ECR 2017 Type: Educational
More informationPictorial essay of unusual radiologic manifestations of pulmonary and airway metastasis at initial presentation of lung cancer
Pictorial essay of unusual radiologic manifestations of pulmonary and airway metastasis at initial presentation of lung cancer Poster No.: C-2297 Congress: ECR 2012 Type: Educational Exhibit Authors: Y.
More informationJune 2013 Pulmonary Case of the Month: Diagnosis Makes a Difference. Lewis J. Wesselius, MD 1 Henry D. Tazelaar, MD 2
June 2013 Pulmonary Case of the Month: Diagnosis Makes a Difference Lewis J. Wesselius, MD 1 Henry D. Tazelaar, MD 2 Departments of Pulmonary Medicine 1 and Laboratory Medicine and Pathology 2 Mayo Clinic
More information