Thoracic CT Findings of Adult T-Cell Leukemia or Lymphoma
|
|
- Eugene Tate
- 6 years ago
- Views:
Transcription
1 Downloaded from by on 12/14/17 from IP address Copyright RRS. For personal use only; all rights reserved Fumito Okada 1 Yumiko ndo Yoshiyuki Kondo Shunro Matsumoto Toru Maeda Hiromu Mori Received May 2, 2003; accepted after revision September 4, ll authors: Department of Radiology, Oita Medical University, Idaigaoka 1-1, Hasama-machi, Oita , Japan. ddress correspondence to F. Okada. JR 2004;182: X/04/ merican Roentgen Ray Society Thoracic CT Findings of dult T-Cell Leukemia or Lymphoma OJECTIVE. The aim of this study was to assess pulmonary CT findings in patients with adult T-cell leukemia or lymphoma. MTERILS ND METHODS. We retrospectively reviewed CT scans of the lung in 87 patients with adult T-cell leukemia or lymphoma who had undergone chest CT between January 1996 and March 2002 at two institutions. The CT scans were interpreted by two chest radiologists working in consensus. Parenchymal abnormalities (ground-glass attenuation, consolidation, nodules, thickening of bronchovascular bundles, interlobular septal thickening, honeycombing, crazy-paving appearance, and bronchiectasis) were evaluated, as were enlarged lymph nodes, pleural effusion, and pleural thickening. In 46 patients who underwent surgical biopsy or autopsy, CT pathologic correlation was performed with the actual specimens by a pathologist and two chest radiologists. RESULTS. On the CT scans, abnormal findings were seen in 60 patients (69.0%). CT findings consisted of ground-glass attenuation (n = 37), centrilobular nodules (n = 25), thickening of bronchovascular bundles (n = 22), and consolidation (n = 13). These abnormalities were predominantly seen in the peripheral lung parenchyma (n = 26). Pathologically, these findings corresponded with atypical lymphocyte infiltration along the interstitium and the alveolar spaces. Pleural effusion and enlarged lymph nodes were found in 22 and 27 patients, respectively. CONCLUSION. CT findings in patients with adult T-cell leukemia or lymphoma consisted mainly of ground-glass attenuation, centrilobular nodules, and thickening of the bronchovascular bundles in the peripheral lung. These findings, although nonspecific, are considered suggestive of thoracic involvement in patients with adult T-cell leukemia or lymphoma. S everal different types of human retrovirus exist, including HIV (referred to as human T-lymphotrophic virus type III before 1990) associated with IDS, and human T-lymphotrophic virus types I, II, and V. Human T- lymphotrophic virus type I, which is prevalent in southwestern Japan and the Caribbean basin [1], is etiologically associated with adult T-cell leukemia or lymphoma and several chronic inflammatory diseases, such as human T-lymphotrophic virus type I associated myelopathy or tropical spastic paraparesis, human T-lymphotrophic virus type I associated arthropathy, human T-lymphotrophic virus type I associated uveitis, and human T-lymphotrophic virus type I associated bronchopulmonopathy. long latency period of years exists between infection with human T-lymphotrophic virus type I and development into adult T-cell leukemia or lymphoma [2]. The cumulative lifetime risk for an infected individual to develop adult T-cell leukemia or lymphoma is estimated to be between 0.5% and 5% [3 5]. Common clinical manifestations of adult T- cell leukemia or lymphoma include lymphadenopathy characterized by sparing of the neck and mediastinum, skin infiltration, hepatosplenomegaly, bone infiltration, general malaise, and gastrointestinal symptoms. It has been reported that infiltration of leukemia cells into the lung is present in 54% of adult T-cell leukemia or lymphoma patients [6]. On chest radiographs, infiltration of the lungs by leukemia cells is characterized by diffuse infiltrate causing opacities in both lungs [7]. To our knowledge, no radiologic studies of pulmonary CT findings in patients with adult T-cell leukemia or lymphoma have been performed. dult T-cell leukemia or lymphoma patients have a high frequency of respiratory complications related to infiltration of the lungs JR:182, March
2 Okada et al. Downloaded from by on 12/14/17 from IP address Copyright RRS. For personal use only; all rights reserved by leukemia cells, and these complications are often life-threatening. The purpose of this study was to assess pulmonary CT findings in patients with adult T-cell leukemia or lymphoma that may be of clinical significance. Materials and Methods We retrospectively reviewed CT scans of the lung in 87 patients (41 men and 46 women; age range, years; mean age, 63 years) with adult T-cell leukemia or lymphoma who had undergone chest CT at the time of diagnosis between January 1996 and March 2002 at two institutions. The approval of our institutional review board was not required for this study. dult T-cell leukemia or lymphoma was diagnosed by positive human T-lymphotrophic virus type I antibody and the presence of abnormal lymphocytes with convoluted nuclei (adult T-cell leukemia or lymphoma cells) in the peripheral blood or histologic findings compatible with a diagnosis of adult T-cell leukemia or lymphoma in biopsied tissue. In 71 of 87 patients, a diagnosis of adult T-cell leukemia or lymphoma was made before performing the CT examinations. Sixteen patients underwent CT before the diagnosis was evident. total of 211 CT scans were obtained for these patients, and IV contrast medium was used in 72 of the procedures. Patients diagnosed with concurrent infectious disease by serologic tests and by clinical and pathologic findings were excluded from this study because these diseases can manifest CT findings such as ground-glass attenuation or consolidation. CT examinations were performed with a HiSpeed dvantage scanner (General Electric Medical Systems, Milwaukee, WI), a HiSpeed LX/i dvantage (General Electric Medical Systems), or an X-press unit (Toshiba, Tokyo, Japan). Sixty-five patients underwent high-resolution CT with 1-mm collimation, and 22 patients underwent CT with 5- to 7-mm collimation. In 54 patients, follow-up CT scans were obtained 8 days 32 months after the initial scan. These CT scans extended from the lung apices to the costophrenic angle. With the HiSpeed dvantage unit, the scanning time of each section was 2.0 sec at 120 kvp and 150 m; with the HiSpeed LX/i dvantage, the scanning time of each section was 2.0 sec at 140 kvp and 160 m; and with the X-press unit, the scanning time was 2.0 sec at 140 kvp and 150 m. ll CT scans were obtained during suspended end inspiration with the patient in the supine position. Two chest radiologists, who were aware of the underlying diagnoses, retrospectively interpreted the chest CT scans and reached their conclusion by consensus. ll initial scans were evaluated. Followup CT was periodically performed on patients who underwent chemotherapy. However, the interval period for follow-up treatment was determined by the chemotherapeutic effect. n average of two sessions per week were reserved for reviewing CT scans, totaling approximately 50 sessions. The CT images were assessed with regard to each of the following radiologic patterns: ground-glass attenuation, consolidation, nodules, thickening of bronchovascular bundles, interlobular septal thickening, honeycombing, crazy-paving appearance, bronchiectasis, enlarged hilar or mediastinal lymph node or nodes (> 1 cm in diameter of the short axis), pleural effusion (unilateral or bilateral), pleural thickening, and pericardial effusion. reas of ground-glass attenuation were defined as hazy increases in attenuation without obscuration of vascular markings. reas of consolidation were defined as areas of increased attenuation that caused obscuration of the normal lung markings with or without air bronchograms. Parenchymal nodules were categorized according to the diameter of the short axis as follows: smaller than 3 mm, between 3 and 10 mm, or larger than 10 mm. If the nodule was identified around peripheral pulmonary arterial branches or 3 5 mm away from the pleura, interlobular septa, or pulmonary veins, it was defined as a centrilobular nodule. The distribution of parenchymal disease was also noted. If the main lesion was located predominantly in the inner third of the lung, the disease was classified as having a central distribution. On the other hand, if the lesion was predominantly in the outer third of the lung, the disease was classified as having peripheral distribution. If the lesions showed no predominant distribution, the disease was classified as having random distribution. In addition, specific zonal predominance was classified into one of three zones; upper, lower, or random. Upper lung zone predominance was considered to be present when most abnormalities were seen at the upper level to the tracheal carina and, likewise, lower zone predominance was considered to be present when most abnormalities were seen below the upper zone. CT pathologic correlation was performed with the actual specimens by a pathologist and two chest radiologists in 46 patients, with autopsy specimens in six, or surgical biopsy in 45, and with both autopsy and surgical specimens in five. utopsy and surgical lung biopsies corresponding to abnormal regions observed on the chest CT scans were performed within 14 and 10 days after the CT scans, respectively. Nine autopsies performed more than 14 days after the CT scans were excluded from this study. Results CT Findings The chest CT scans revealed abnormalities in 60 (69.0%) of 87 patients with adult T-cell leukemia or lymphoma (Table 1). Of those 60 patients, 45 were found to have parenchymal abnormalities. mong these 45 patients, ground-glass attenuation (n = 37, 61.7%) (Figs. 1 3) was the most frequently seen, followed by centrilobular nodules (n = 25, 41.7%) (Figs. 3 and 4). Thickening of bronchovascular bundles (n = 22, 36.7%) (Figs. 3 TLE 1 Thoracic CT Findings in 60 Patients Finding No. (%) of Patients Ground-glass attenuation 37 (62) Centrilobular nodules 25 (42) Thickening of bronchovascular 22 (37) bundles Interlobular septal thickening 17 (28) Nodules > 10 mm 13 (22) Consolidation 13 (22) Honeycombing 1 (2) Crazy-paving appearance 4 (7) ronchiectasis 13 (22) Pleural thickening 6 (10) Pleural effusion 22 (37) Pericardial effusion 4 (7) Lymph node enlargement 27 (45) and 5), interlobular septal thickening (n = 17, 28.3%) (Fig. 1), and areas of consolidation (n = 13, 21.7%) (Fig. 6) were also observed frequently. Nodules smaller than 3 mm in diameter were identified in 28 patients (46.7%), and nodules between 3 and 10 mm in diameter were identified in seven patients (11.7%). Nodules greater than 10 mm in diameter were seen in 13 patients (21.7%) (Fig. 7). ronchiectasis was also observed in 13 patients (21.7%). The combination of ground-glass attenuation and centrilobular nodules (n = 20, 44.4%) was seen most frequently, followed by ground-glass attenuation and interlobular septal thickening (n = 15, 33.3%). The combination of ground-glass attenuation and consolidation was seen in 13 patients (21.7%). Some ground-glass attenuation was detected in areas near consolidation or in areas without consolidation. The ground-glass attenuation was often irregularly confluent. In the 45 patients with parenchymal disease, abnormal findings were seen predominantly in the peripheral lung (26/45, 57.8%). On the other hand, there were no patients with disease showing a predominantly central distribution. The predominant zonal distribution was in the lower zone in 12 patients (26.7%) and in the middle zone in four (8.9%); random distribution was observed in 28 (62.2%). On follow-up CT (n = 54), ground-glass attenuation (n = 35) had disappeared in 14 patients, improved in 18, remained unchanged in two, and worsened in one after treatment. Thickening of bronchovascular bundles (n = 20) disappeared in seven patients, improved in 10, and remained unchanged in three. Interlobular 762 JR:182, March 2004
3 Downloaded from by on 12/14/17 from IP address Copyright RRS. For personal use only; all rights reserved CT of T-Cell Leukemia or Lymphoma Fig. 1. dult T-cell leukemia or lymphoma (acute type) in 75-year-old woman., High-resolution CT scan obtained at level of left upper lobe shows ground-glass attenuation in peripheral distribution. Note interlobular septal thickening (arrow)., Photomicrograph of autopsy specimen obtained from left upper lobe shows atypical lymphocytes infiltrating interstitium (arrows), with small nodule formation (arrowheads). (H and E, 100) Fig. 2. dult T-cell leukemia or lymphoma (acute type) in 49-year-old woman. High-resolution CT scan obtained 2 cm below carina shows fine reticular pattern superimposed on background of ground-glass attenuation, crazy-paving pattern. Right pleural effusion is also present. Fig. 3. dult T-cell leukemia or lymphoma (lymphoma type) in 30-year-old man., High-resolution CT scan obtained 3 cm below level of tracheal carina shows centrilobular nodules. ilateral pleural effusion is also present., Photomicrograph of surgical biopsy specimen obtained from right upper lobe shows lymphocytes with mild nuclear atypia infiltrating along bronchovascular bundles with mild fibrosis. (H and E, 100) JR:182, March
4 Downloaded from by on 12/14/17 from IP address Copyright RRS. For personal use only; all rights reserved Okada et al. Fig. 4. dult T-cell leukemia or lymphoma (smoldering type) in 23-year-old woman., High-resolution CT scan obtained at level of dome of right hemidiaphragm shows centrilobular nodules (tree-in-bud pattern) and mild thickening of bronchial walls. Note mild bronchiectasis., Photomicrograph of surgical biopsy specimen obtained from right lower lobe shows atypical and mildly atypical lymphocytes infiltrating wall of respiratory bronchioles extending into adjacent peribronchiolar interstitium. (H and E, 40) septal thickening (n = 16) disappeared in 13 patients and improved in three. The areas of consolidation (n = 12) disappeared in five patients (Fig. 6), improved in six, and worsened in one. Nodules (n = 13) disappeared in all patients. There were small effusions in eight patients, moderately sized effusions in 11, and large effusions in three. ilateral effusion was observed in 13 patients and unilateral effusion, in nine (Figs. 2, 3, and 8). No parenchymal abnormalities were observed in patients with pleural effusion (bilateral in five, unilateral in four). Pleural effusion disappeared in 18 patients and improved in four after chemotherapy. Mediastinal and hilar lymph node enlargement (11 82 mm) was found in 27 patients (45%) (Fig. 8). Enlarged lymph nodes were generally found at the pretracheal, paratracheal, tracheobronchial, or subcarinal regions. No parenchymal abnormalities were observed in eight patients with lymph node enlargement. fter treatment, lymph node enlargement improved in 23 patients and remained unchanged in three on follow-up CT scans. Enlarged lymph nodes were also found in both axillary regions in six patients. Less common CT findings included pulmonary fibrosis such as honeycombing (n = 1) and pericardial effusion (n = 4). CT Pathologic Correlation Fig. 5. dult T-cell leukemia or lymphoma (acute type) in 34-year-old man. High-resolution CT scan obtained at level of bifurcation of middle lobe bronchus shows thickening of bronchovascular bundles (arrow). Note small nodules (arrowheads). 764 In 46 patients who underwent surgical biopsy or autopsy, CT findings were correlated with pathologic findings. The extent of centrilobular nodules corresponded pathologically with that of atypical lymphocytic infiltration along the respiratory bronchioles. In addition, thickening of the bronchovascular bundles corresponded with infiltration of atypical lymphocytes along the bronchovascular bundles (Fig. 3). The extent of ground-glass attenuation also corresponded with that of atypical lymphocytic infiltration into the interstitium, together with small nodular formations (Fig. 1). The consolidation corresponded to the atypical lymphocytic infiltration in the interstitium and the alveolar spaces, as well as with mild congestive change (Fig. 6). Furthermore, interlobular septal thickening and pleural thickening corresponded with the infiltration of numerous atypical lymphocytes into both the pleura and the interlobular septa (Fig. 8). In five patients, both surgical biopsy and autopsy were performed, and the histologic findings of the surgical biopsies were almost identical to those of the autopsy specimens. Discussion Several different types of human retroviruses exist, including HIV (referred to as human T-lymphotrophic virus type III before 1990) associated with IDS, and human Tlymphotrophic virus types I, II, and V. Human T-lymphotrophic virus type I, which is endemic in southwestern Japan and other isolated regions of the world, is associated with a variety of human diseases, including adult Tcell leukemia or lymphoma and nonneoplastic inflammatory disease [8]. ntibodies against human T-lymphotrophic virus type I have been found in more than 1 million people in Japan, and approximately 500 patients develop adult T-cell leukemia or lymphoma annually. Human T-lymphotrophic virus type I is most often transmitted vertically via breast feeding and occasionally by blood transfusion. Specific risk factors for developing adult T-cell leukemia or lymphoma remain unclear. dult T-cell leukemia or lymphoma, which is defined as a neoplastic clonal growth of human JR:182, March 2004
5 Downloaded from by on 12/14/17 from IP address Copyright RRS. For personal use only; all rights reserved CT of T-Cell Leukemia or Lymphoma C D Fig. 6. dult T-cell leukemia or lymphoma (smoldering type) in 35-year-old man., Initial CT scan obtained at level of inferior pulmonary vein shows consolidation in peripheral distribution., Photomicrograph of surgical biopsy specimen obtained from left lower lobe shows numerous atypical lymphocytes infiltrating into interstitium. Note mild congestive change. (H and E, 40) C, fter treatment, follow-up CT scan shows improvement of consolidation. D, Follow-up CT scan obtained 11 months after C shows recurrence of consolidation in right upper lobe, where consolidation had not been visualized on initial scan. Fig. 7. dult T-cell leukemia or lymphoma (acute type) in 73year-old man., High-resolution CT scan obtained at level of division of middle lobe bronchus shows nodules with air bronchogram in middle lobe., High-resolution CT scan obtained at level of division of lingular bronchus in left lung shows two nodules with air bronchogram. JR:182, March
6 Okada et al. Downloaded from by on 12/14/17 from IP address Copyright RRS. For personal use only; all rights reserved T-lymphotrophic virus type I infected T-cells, can present as various clinical manifestations by involving many organs, including the lungs and skin, and the gastrointestinal tract, central nervous system, and bones [9]. ecause adult T-cell leukemia or lymphoma patients present with such a variety of clinical symptoms and courses, it is difficult for the clinician to differentiate between acute disease necessitating immediate treatment and chronic disease that does not require specific treatment. dult T-cell leukemia or lymphoma is classified into four clinical subtypes. The first is the smoldering type, in which more than 5% of T lymphocytes are abnormal, the peripheral blood contains less than 4,000/µL of lymphocytes, and few abnormal blood chemistry profiles and adult T-cell leukemia or lymphoma infiltration are present. The second is the chronic type, in which lymphocytosis occurs (defined as T lymphocytosis > 4,000/µL), lactate dehydrogenase is less than twice the normal upper limit, and no hypercalcemia is present, with possible lymph node, liver, spleen, skin, and lung involvement. The third is the lymphoma type, in which histologically proven lymph node enlargement is present but no lymphocytosis is present (defined as < 1% abnormal T lymphocytes). The fourth is the acute type, for patients not classified into any of the above three types [10]. The relative percentage of adult T-cell leukemia or lymphoma cases for each lymphoma type is 55% for the acute type, 20% for the lymphoma Fig. 8. dult T-cell leukemia or lymphoma (acute type) in 38-year-old woman., CT scan obtained at level of tracheal carina shows plaquelike thickening of pleura (arrows). Right pleural effusion and lymph node enlargement (arrowheads) can also be identified., Photomicrograph of surgical biopsy specimen obtained from right lower lobe shows numerous atypical lymphocytes infiltrating both pleura and interlobular septa (arrow). Note foamy cells existing in some alveoli. (H and E 40) type, 20% for the chronic type, and 5% for the smoldering type. The median survival time is 6.2 months for the acute type, 10.2 months for the lymphoma type, and 24.3 months for the chronic type; 62.8% of patients with the smoldering type were still alive after 4 years [10]. dult T-cell leukemia or lymphoma has a poor prognosis due to life-threatening complications, including infections and hypercalcemia [11]. mong the infectious complications, cytomegalovirus is most frequently encountered in patients at autopsy. Pneumocystis carinii and spergillus and Candida organisms are also encountered as opportunistic infections [6, 8]. Patients with adult T-cell leukemia or lymphoma have a high frequency of respiratory complications, consisting of the infiltration of leukemia cells and pulmonary hemorrhage. It has been reported that 93.1% of adult T-cell leukemia or lymphoma patients (n = 29) presented with respiratory complications, such as tumor infiltration and infection, during the clinical course of the disease [8]. Sato et al. [6] reported that infiltration of the lung by leukemia cells was present in 54% of adult T-cell leukemia or lymphoma patients in an autopsy study. The infiltration of the lung by leukemia cells is characterized by diffuse infiltrate in shadows of both lungs observed on chest radiographs [7]. It was previously reported that 12 (34%) of 35 patients with adult T-cell leukemia or lymphoma had significant findings on chest radiographs; a reticulonodular pattern of disease, seen in 10 patients, was the most common finding [12]. To our knowledge, there have been no radiologic studies of pulmonary CT findings in patients with adult T-cell leukemia or lymphoma. We retrospectively reviewed pulmonary CT findings in 87 patients with adult T- cell leukemia or lymphoma. Of those patients, 60 (69.0%) showed abnormalities; the most common CT findings were ground-glass attenuation, followed by centrilobular nodules and thickening of bronchovascular bundles. The extent of ground-glass attenuation corresponded to that of atypical lymphocytic infiltration into the interstitium, with the formation of small nodules. In addition, centrilobular nodules and thickening of bronchovascular bundles corresponded to the presence of atypical lymphocytes along the bronchovascular bundles and mild fibrosis. Okura et al. [13] reported the first case of a nodular pattern of disease observed in the right mid lung on a chest radiograph, in which only a large nodular accumulation of adult T-cell leukemia or lymphoma cells was observed, without diffuse infiltration of the cells into the lung. In our study, 22% of patients had pulmonary nodules with or without air bronchograms. Maruyama et al. [14] reported a crazy-paving appearance on high-resolution CT in various diseases such as alveolar proteinosis, P. carinii pneumonia, pulmonary hemorrhage, and drug-induced pneumonia. The crazy-pav- 766 JR:182, March 2004
7 CT of T-Cell Leukemia or Lymphoma Downloaded from by on 12/14/17 from IP address Copyright RRS. For personal use only; all rights reserved ing appearance, representing thickened interlobular septa between secondary lobules, has not been previously reported in a patient with adult T-cell leukemia or lymphoma. Here, we identified this CT finding in four patients (7%) with adult T-cell leukemia or lymphoma. Human T-lymphotrophic virus type I associated bronchopulmonary disorder can be staged in a variety of ways. Kimura [15] described a close relationship between diffuse panbronchiolitis, or idiopathic interstitial pneumonia, and human T-lymphotrophic virus type I. In that article, it was speculated that the accumulation of precancerous lymphoid cells in the bronchoalveolar areas would lead to diffuse panbronchiolitis or idiopathic interstitial pneumonia due to the host s response; a significant number of patients would eventually enter a stage of overt adult T-cell leukemia or lymphoma. In our study, centrilobular nodules and mild thickening of the bronchial wall were seen in 25 and 22 patients, respectively. These CT findings were confirmed to be due to atypical and mildly atypical lymphocytic infiltration, respectively, of the respiratory bronchioles wall, as determined at surgical biopsy. However, the possibility that these CT findings were related to chronic infection or human T-lymphotrophic virus type I associated bronchopulmonary disorder could not be completely ruled out because mildly atypical lymphocytes were present. On the other hand, CT findings of pulmonary fibrosis (i.e., honeycombing) were found in only one patient (2%). This result is probably due to the fact that patients with collagen disease or collagen-related disease were excluded from this study. Furthermore, none of the patients had significant fibrotic disease in the upper lobe, which is frequently seen in patients with chronic hypersensitivity pneumonitis, sarcoidosis, or pneumoconiosis. Pleural effusion and thickening are commonly observed in patients with leukemia. These signs appear mainly in cases of acute lymphoblastic leukemia and have been recognized in 27% of leukemia patients at autopsy [16]. However, the CT manifestations of pleural disease caused by adult T-cell leukemia or lymphoma have not been previously described. plaquelike pleural thickening on CT scans was seen in six patients (10%) with adult T-cell leukemia or lymphoma in our study. The biopsy specimens obtained from the lung showed numerous atypical lymphocytes infiltrating the pleura, and foamy cells were present in some of the alveoli. Pleural involvement with adult T- cell leukemia or lymphoma has a nonspecific appearance; therefore, radiologists should be aware that pleural thickening can be caused not only by infection or pulmonary congestion but also by adult T-cell leukemia or lymphoma infiltration in patients with the diagnosis of adult T-cell leukemia or lymphoma. Generalized lymphadenopathy is a common manifestation of adult T-cell leukemia or lymphoma. Peripheral lymphadenopathy is reported in % of adult T-cell leukemia or lymphoma patients [9]; hilar, intraabdominal, paraaortic, and paracaval lymphadenopathies are seen in up to 50% of these patients. The results of the present study regarding lymphadenopathy (45%) were similar to those of previous reports. It should be noted that there were several limitations of the present study. First, this was a retrospective study, and the CT findings were not sufficiently correlated with the pathologic findings because some patients were in poor general health. In addition, the CT scans and histologic specimens were not obtained on the same day, although the surgical biopsies were performed within 10 days after the CT scans. Second, with regard to the CT findings, the relationship between adult T-cell leukemia or lymphoma and human T-lymphotrophic virus type I associated bronchopulmonary disorder remains unclear. Third, it is difficult to distinguish these CT findings from those associated with cytomegalovirus infection or hemorrhage in patients with adult T-cell leukemia or lymphoma who did not have the pathologic evidence required for diagnosis. Cytomegalovirus infection, which is the most common opportunistic infection in the lungs, can cause some of the common high-resolution CT patterns (i.e., ground-glass attenuation, interstitial thickening, and nodules) described in our earlier article [17]. Similarly, hemorrhage can cause nonspecific areas of ground-glass attenuation or consolidation [14, 18]. Finally, some of the CT examinations were performed several years ago, and, more important, not all the CT studies included 1-mm high-resolution images. If all patients had undergone high-resolution CT, the abnormal CT findings may have had a different frequency than that observed in our study. In summary, the pulmonary CT findings in patients with adult T-cell leukemia or lymphoma consisted mainly of ground-glass attenuation, centrilobular nodules, thickening of bronchovascular bundles, and interlobular septal thickening in the peripheral lung. These findings corresponded pathologically with atypical lymphocytic infiltration along the interstitium and the alveolar spaces. Moreover, pleural effusion and lymph node enlargement were commonly observed among the patients. These CT findings are considered suggestive of adult T-cell leukemia or lymphoma pulmonary infiltration in patients with the diagnosis of adult T-cell leukemia or lymphoma. References 1. Gibbs WN, Lofters WS, Campbell M, et al. Non- Hodgkin lymphoma in Jamaica and its relation to adult T-cell leukemia-lymphoma. nn Intern Med 1987;106: Cann J, Chen ISY. Human T-cell leukemia virus types I and II. In: Fields N, Knipe DM. eds. Virology, 2nd ed. New York, NY: Raven Press 1990: Weber J. HTLV-1 infection in ritain. (editorial) r Med J 1990;301: Dixon C, Dixon PS, Nakamura JM. Infection with the human T-lymphotropic virus type 1: a review for clinicians. Wes J Med 1989;151: [No authors listed] HTLV-1 comes of age. (editorial) Lancet 1988;1: Sato E, Hasui K, Tokunaga M. utopsy findings of adult T cell lymphoma-leukemia. Gann Monogr Cancer Res 1982;28: Makino T, Utsunomiya, Uozumi K, et al. Clinicopathological studies of chest x-ray findings in 54 adult T-cell leukemia patients. cta Haematol 1987;49: Yoshioka R, Yamaguchi K, Yoshinaga T, Takatsuki K. Pulmonary complications in patients with adult T-cell leukemia. Cancer 1985;55: George CD, Wilson G, Philpott NJ, evan DH. The radiological features of adult T-cell leukemia/lymphoma. Clin Radiol 1994;49: Shimoyama M, Takatsuki K, raki K, et al. Diagnostic criteria and classification of clinical subtypes of adult T-cell leukaemia-lymphoma: a report from the Lymphoma Study Group. r J Haematol 1991;79: Senba M, Nakamura T, Kawai K, Senba MI. HTLV-1 and acute pancreatitis. (letter) Lancet 1991;337: Tamura K, Yokota T, Mashita R, Tamura S. Pulmonary manifestations in adult T-cell leukemia at the time of diagnosis. Respiration 1993;60: Okura T, Tanaka R, Shibata H, Kukita H. dult T- cell leukemia with solitary lung mass. Chest 1992;101: Maruyama S, Murkami J, Yabuuchi H, Soeda H, Masuda K. Crazy paving appearance on highresolution CT in various diseases. J Comput ssist Tomogr 1999;23: Kimura I. HTLV-1 associated bronchiolo-alveolar disorder (H) [in Japanese]. Nihon Kyobu Shikkan Gakkai Zasshi 1988;47: Viadana E, ross DJ, Pickren JW. n autopsy study of the metastatic patterns of human leukemias. Oncology 1978;35: McGuinness G, Scholes JV, Garay SM, Leitman S, McCauley DI, Naidich DP. Cytomegalovirus pneumonitis: spectrum of parenchymal CT findings with pathologic correlation in 21 IDS patients. Radiology 1994;192: rown MJ, Miller RR, Muller NL. cute lung disease in the immunocompromised host: CT and pathologic examination findings. Radiology 1994; 190: JR:182, March
Pulmonary 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 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 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 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 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 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 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 informationAn 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 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 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 informationPulmonary Alveolar Microlithiasis: CT and pathologic findings in 10 patients
Monaldi Arch Chest Dis 2005; 63: 1, 59-64 CASE REPORT Pulmonary Alveolar Microlithiasis: CT and pathologic findings in 10 patients H. Sumikawa 1,T. Johkoh 1, 2, N. Tomiyama 1, S. Hamada 1, M. Koyama 1,
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 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 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 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 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 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 informationCytomegalovirus Pneumonia: High-Resolution CT Findings in Ten Non-AIDS Immunocompromised Patients
Cytomegalovirus Pneumonia: High-Resolution CT Findings in Ten Non-AIDS Immunocompromised Patients Jeung Hee Moon, MD 1 Eun A Kim, MD 1 Kyung Soo Lee, MD 1 Tae Sung Kim, MD 1 Kyung-Jae Jung, MD 1 Jae-Hoon
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 informationMarc Bazot, MD; Jacques Cadranel, MD; Sylvie Benayoun, MD; Marc Tassart, MD; Jean Michel Bigot, MD; and Marie France Carette, MD
Primary Pulmonary AIDS-Related Lymphoma* Radiographic and CT Findings Marc Bazot, MD; Jacques Cadranel, MD; Sylvie Benayoun, MD; Marc Tassart, MD; Jean Michel Bigot, MD; and Marie France Carette, MD Study
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 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 informationComparison of High-resolution CT Findings between Miliary Metastases and Miliary Tuberculosis 1
Comparison of High-resolution CT Findings between Miliary Metastases and Miliary Tuberculosis 1 Chan Sung Kim, M.D., Ki-Nam Lee, M.D., Jin Hwa Lee, M.D. Purpose: To compare the findings of high-resolution
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 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 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 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 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 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 informationPulmonary Computed Tomography Findings in 39 Cases of Streptococcus pneumoniae Pneumonia
ORIGINAL ARTICLE Pulmonary Computed Tomography Findings in 39 Cases of Streptococcus pneumoniae Pneumonia Attiya Haroon 1, Futoshi Higa 1, Jiro Fujita 1, Akira Watanabe 2, Nobuki Aoki 3, Yoshihito Niki
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 informationThoracic Manifestations of Sarcoidosis Using Multi-Slice CT
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 14, Issue 9 Ver. II (Sep. 2015), PP 63-68 www.iosrjournals.org Thoracic Manifestations of Sarcoidosis
More informationCT findings in multifocal or diffuse non-mucinous bronchioloalveolar carcinoma (BAC)
CT findings in multifocal or diffuse non-mucinous bronchioloalveolar carcinoma (BAC) Poster No.: C-2192 Congress: ECR 2014 Type: Educational Exhibit Authors: I. Sandu, A. R. Popita, I.-A. Brumboiu; Cluj-Napoca/RO
More informationCT findings in multifocal or diffuse non-mucinous bronchioloalveolar carcinoma (BAC)
CT findings in multifocal or diffuse non-mucinous bronchioloalveolar carcinoma (BAC) Poster No.: C-2192 Congress: ECR 2014 Type: Educational Exhibit Authors: I. Sandu, A. R. Popita, I.-A. Brumboiu; Cluj-Napoca/RO
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 informationKey words: CT scanners; interstitial lung diseases; polymyositis-dermatomyositis; x-ray
Nonspecific Interstitial Pneumonia Associated With Polymyositis and Dermatomyositis* Serial High-Resolution CT Findings and Functional Correlation Hiroaki Arakawa, MD; Hidehiro Yamada, MD; Yasuyuki Kurihara,
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 informationImaging findings in Hypersensitivity Pneumonitis - a pictorical review.
Imaging findings in Hypersensitivity Pneumonitis - a pictorical review. Poster No.: C-1655 Congress: ECR 2014 Type: Educational Exhibit Authors: B. M. Araujo, A. F. S. Simões, M. S. C. Rodrigues, J. Pereira;
More informationThoracic CT pattern in lung cancer: correlation of CT and pathologic diagnosis
19 th Congress of APSR PG of Lung Cancer (ESAP): Update of Lung Cancer Thoracic CT pattern in lung cancer: correlation of CT and pathologic diagnosis Kazuma Kishi, M.D. Department of Respiratory Medicine,
More informationRadiologists toolbox to differentiate alveolar versus interstitial lung diseases
Radiologists toolbox to differentiate alveolar versus interstitial lung diseases Dr Sumer Shikhare, Dr Trishna Shimpi, Dr Ashish Chawla Khoo Teck Puat Hospital Singapore. Relevant financial disclosures
More informationChest XRay interpretation INTERPRETATIONS Identifications: Name & Date Technical evaluation Basic Interpretations
Chest XRay interpretation INTERPRETATIONS Identifications: Name & Date Technical evaluation Basic Interpretations TECHNICAL EVALUATION 1. Projection: AP/PA view To differentiate between AP & PA films,
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 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 informationIdiopathic interstitial pneumonias (IIPs) are a group of
SYMPOSIA C. Isabela S. Silva, MD, PhD and Nestor L. Müller, MD, PhD Abstract: The idiopathic interstitial pneumonias (IIPs) are a group of diffuse parenchymal lung diseases of unknown etiology characterized
More informationChest X-ray (CXR) Interpretation Brent Burbridge, MD, FRCPC
Chest X-ray (CXR) Interpretation Brent Burbridge, MD, FRCPC An approach to reviewing a chest x-ray will create a foundation that will facilitate the detection of abnormalities. You should create your own
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 informationCryptogenic Organizing Pneumonia: Serial High-Resolution CT Findings in 22 Patients
Cardiopulmonary Imaging Original Research Lee et al. High-Resolution CT of Cryptogenic Organizing Pneumonia Cardiopulmonary Imaging Original Research Ju Won Lee 1 Kyung Soo Lee 1 Ho Yun Lee 1 Man Pyo Chung
More informationRole of Computed Tomography in Diagnosis of Diffuse Lung Diseases Chauhan Jayant 1*, Panchal Pankaj 2, Faruqui Tehzeeb 3
ORIGINAL ARTICLE Role of Computed Tomography in Diagnosis of Diffuse Lung Diseases Chauhan Jayant 1*, Panchal Pankaj 2, Faruqui Tehzeeb 3 1 MD,DTCD,Additional Professor& HOD, 2,3 MBBS, 3 rd year resident
More informationPULMONARY TUBERCULOSIS RADIOLOGY
PULMONARY TUBERCULOSIS RADIOLOGY RADIOLOGICAL MODALITIES Medical radiophotography Radiography Fluoroscopy Linear (conventional) tomography Computed tomography Pulmonary angiography, bronchography Ultrasonography,
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 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 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 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 informationThe Egyptian Journal of Hospital Medicine (July 2017) Vol.68 (2), Page
The Egyptian Journal of Hospital Medicine (July 2017) Vol.68 (2), Page 1135-1140 Role of High Resolution Computed Tomography in Diagnosis of Interstitial Lung Diseases in Patients with Collagen Diseases
More informationMimics in chest disease: interstitial opacities
Insights Imaging (2013) 4:9 27 DOI 10.1007/s13244-012-0207-7 PICTORIAL REVIEW Mimics in chest disease: interstitial opacities Anastasia Oikonomou & Panos Prassopoulos Received: 19 June 2012 / Revised:
More informationProgress in Idiopathic Pulmonary Fibrosis
Progress in Idiopathic Pulmonary Fibrosis David A. Lynch, MB Disclosures Progress in Idiopathic Pulmonary Fibrosis David A Lynch, MB Consultant: t Research support: Perceptive Imaging Boehringer Ingelheim
More informationImaging Spectrum of Allergic Lung Disease: Hypersensitivity Reactions on the Lung Parenchyma
Imaging Spectrum of Allergic Lung Disease: Hypersensitivity Reactions on the Lung Parenchyma Moon Sung Kim 1, Ki-Nam Lee 1, Won Jin Choi 1, Bo Ra Kim 1, Eun-Ju Kang 1 1 Department of Radiology, Dong-A
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 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 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 informationRespiratory Interactive Session. Elaine Borg
Respiratory Interactive Session Elaine Borg Case 1 Respiratory Cytology 55 year old gentleman Anterior mediastinal mass EBUS FNA Case 1 Respiratory Cytology 55 year old gentleman with anterior mediastinal
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 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 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 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 informationLung CT: Part 2, The Interstitial Pneumonias Clinical, Histologic, and CT Manifestations
Integrative Imaging Review Ferguson and Berkowitz CT of Interstitial Pneumonia Integrative Imaging Review CME SAM Lung CT FOCUS ON: Emma C. Ferguson 1 Eugene A. Berkowitz 2 Ferguson EC, Berkowitz EA Keywords:
More informationChest X-ray Interpretation
Chest X-ray Interpretation Introduction Routinely obtained Pulmonary specialist consultation Inherent physical exam limitations Chest x-ray limitations Physical exam and chest x-ray provide compliment
More informationBronchioloalveolar Carcinoma Mimicking DILD:
Bronchioloalveolar Carcinoma Mimicking DILD: A Case Report 1 Ju Young Lee, M.D., In Jae Lee, M.D., Dong Gyu Kim, M.D. 2, Soo Kee Min, M.D. 3, Min-Jeong Kim, M.D., Sung Il Hwang, M.D., Yul Lee, M.D., Sang
More informationAmerican College of Radiology ACR Appropriateness Criteria
American College of Radiology ACR Criteria Radiologic Management of Thoracic Nodules and Masses Variant 1: Middle-aged patient (35 60 years old) with an incidental 1.5-cm lung nodule. The lesion was smooth.
More informationChest imaging II. Interstitial lung diseases
Chest imaging II. Interstitial lung diseases Dávid L. Tárnoki MD, PhD Ádám D. TárnokiMD, PhD Department of Radiology Semmelweis University Topics 1. Interstitial lung diseases 2. Occupational lung diseases
More informationRadiologic-pathologic correlation of pulmonary diseases
The 1578 th Chest Conference/ 3 rd Biennial Clinical- Radiologic-Pathologic Correlation Radiologic-pathologic correlation of pulmonary diseases Harumi Itoh, M.D. University of Fukui, Japan Centriacinar
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 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 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 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 informationThe radiological differential diagnosis of the UIP pattern
5th International Conference on Idiopathic Pulmonary Fibrosis, Modena, 2015, June 12th The radiological differential diagnosis of the UIP pattern Simon Walsh King s College Hospital Foundation Trust London,
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 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 informationDiagnostic Imaging of Diffuse Infiltrative Disease of the Lung
Thematic Review Series Respiration 2004;71:4 19 DOI: 10.1159/000075642 Diagnostic Imaging of Diffuse Infiltrative Disease of the Lung Maurizio Zompatori a Claudio Bnà a Venerino Poletti c Enrica Spaggiari
More informationThin-Section CT Findings of Arc-Welders Pneumoconiosis
Thin-Section CT Findings of Arc-Welders Pneumoconiosis Daehee Han, MD 1 Jin Mo Goo, MD 1 Jung-Gi Im, MD 1 Kyung Soo Lee, MD 2 Do Myung Paek, MD 3 Seong Ho Park, MD 1 Index words: Lungs, diseases Lungs,
More informationPulmonary fibrosis on the lateral chest radiograph: Kerley D lines revisited
Insights Imaging (2017) 8:483 489 DOI 10.1007/s13244-017-0565-2 PICTORIAL REVIEW Pulmonary fibrosis on the lateral chest radiograph: Kerley D lines revisited Daniel B. Green 1 & Alan C. Legasto 1 & Ian
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 Screening for Lung Cancer: Frequency and Significance of Part-Solid and Nonsolid Nodules
Claudia I. Henschke 1 David F. Yankelevitz 1 Rosna Mirtcheva 1 Georgeann McGuinness 2 Dorothy McCauley 1 0lli S. Miettinen 3 for the ELCAP Group Received June 19, 2001; accepted after revision November
More information8/14/2017. Objective: correlate radiographic findings of common lung diseases to actual lung pathologic features
What is that lung disease? Pulmonary Patterns & Correlated Pathology Dr. Russell Tucker, DACVR Objective: correlate radiographic findings of common lung diseases to actual lung pathologic features Improved
More informationInterpretation of Chest Radiographs Paul Christensen, MD 10/21/09. Diagnostic Evaluation. Medical Evaluation & CXR Interpretation.
Diagnostic Evaluation Medical Evaluation & CXR Interpretation University of Michigan TB Consultant Washtenaw County Medical history Physical examination Testing for TB exposure (previously covered) Radiologic
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 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 informationNew lung lesion in a 55 year-old male treated with chemoradiation for non-small cell lung carcinoma
July 2016 New lung lesion in a 55 year-old male treated with chemoradiation for non-small cell lung carcinoma Contributed by: Laurel Rose, MD, Resident Physician, Indiana University School of Medicine,
More informationDilemma of Thoracic Tuberculosis Vs. Sarcoidosis in TB Endemic Areas: An Imaging Approach
Dilemma of Thoracic Tuberculosis Vs. Sarcoidosis in TB Endemic Areas: An Imaging Approach A. S. Bhalla, A. Das, A. GOYAL, P. NARANJE, R. GULERIA, G. C. KHILNANI ALL INDIA INSTITUTE OF MEDICAL SCIENCES
More informationCT findings of high-attenuation pulmonary abnormalities
Insights Imaging (2010) 1:287 292 DOI 10.1007/s13244-010-0039-2 PICTORIAL REVIEW CT findings of high-attenuation pulmonary abnormalities Naim Ceylan & Selen Bayraktaroglu & Recep Savaş & Hudaver Alper
More informationCystic Lung Disease: a Comparison of Cystic Size, as Seen on Expiratory and Inspiratory HRCT Scans
Cystic Lung Disease: a Comparison of Cystic Size, as Seen on Expiratory and Inspiratory HRCT Scans Ki-Nam Lee, MD 1 Seong-Kuk Yoon, MD 1 Seok Jin Choi, MD 2 Jin Mo Goo, MD 3 Kyung-Jin Nam, MD 1 Index words:
More informationDifferential Diagnosis in Conventional Radiology
Differential Diagnosis in Conventional Radiology Bearbeitet von Francis A. Burgener, Martti Kormano, Tomi Pudas Neuausgabe 2007. Buch. 872 S. Hardcover ISBN 978 3 13 656103 4 Format (B x L): 21 x 29,7
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 informationOBJECTIVES. Solitary Solid Spiculated Nodule. What would you do next? Case Based Discussion: State of the Art Management of Lung Nodules.
Organ Imaging : September 25 2015 OBJECTIVES Case Based Discussion: State of the Art Management of Lung Nodules Dr. Elsie T. Nguyen Dr. Kazuhiro Yasufuku 1. To review guidelines for follow up and management
More informationUndergraduate Teaching
Prof. James F Meaney Undergraduate Teaching Chest X-Ray Understanding the normal anatomical by reference to cross sectional imaging Radiology? It s FUN! Cryptic puzzle Sudoku (Minecraft?) It s completely
More informationImaging of the Lung. István Battyány
Imaging of the Lung István Battyány Anatomy of airways: (asszimetric dichotomy) trachea Main bronchus Lobar bronchus }lung, lobe 1. segmental bronchus subsegmental bronchus bronchus lobularis bronchiolus
More information