Cystic Lung Disease. Cristopher A. Meyer, MD

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Cystic Lung Disease. Cristopher A. Meyer, MD"

Transcription

1 Cystic Lung Disease Cristopher A. Meyer, MD Air filled structure with definable wall typically less than 1 mm thick Cris A. Meyer, M.D. Professor of Radiology University of Wisconsin School of Medicine and Public Health Langerhans Cell Histiocytosis Thin section CT 56 asymptomatic patients: older than 75 Younger than 55 Cysts in 10/40 older subjects and none of younger subjects (p=.02) Uniform distribution Copley SJ et al. Radiology 2009; 251: Langerhans Cell Histiocytosis (LCH) Lymphangioleiomyomatosis (LAM) Chronic Hypersensitivity Pneumonitis Lymphocytic Interstitial Pneumonia/Follicular Bronchiolitis (LIP/FB) Light Chain Deposition Disease Birt-Hogg-Dube Syndrome Cystic Metastases 60 LCH - mixed inflammatory nodule LAM smooth muscle proliferation Subacute/Chronic HP - peribronchial lymphoplasmacytoid infiltrate and OB LIP/FB lymphocytic inflammatory proliferation along BALT Amyloid/LCDD peribronchiolar extracellular protein deposition

2 2nd-4th decade, smokers >90% Sx: cough, dyspnea, PTX up to 20%. Bronchiolocentric mixed inflammatory lesions result in perifibrotic airspace enlargement, bronchiolar mural destruction and luminal dilation Pulmonary artery involvement may lead to intimal fibrosis and pulmonary HTN (LCH vasculopathy) Air cysts, <1cm, bizarre (late) Air trapping CP angles, anterior tips of RML and lingula spared* Adenopathy (rare) Pleural effusions (rare) Abbot GF et al. From the Archives of the AFIP: Pulmonary Langerhans Cell Histiocytosis. Radiographics 2004; 24: 827. Illustration courtesy of Dr. A. Frazier 61

3 25 y.o. heavy smoker with recurrent pneumothoraces 50 y.o. >20 pk-yr smoker with night sweats and dyspnea X 6 months. Air cysts Adenopathy Patchy ground glass No large nodules Diffuse fine nodules of MMPH in 28-43% (TSC > S-LAM) Chylous pleural effusion Air trapping 62 Proliferation of smooth muscle-like spindle cells along axial lymphatics of the chest and abdomen Sporadic LAM (S-LAM) and Tuberous Sclerosis Complex TSC-LAM is up to 10x more common than S-LAM (30% of women with TSC vs 1:1,000,000 S-LAM) Genetic dysregulation of mtor signaling results in perivascular epithelioid cell tumors (PEComas: AML, LAM and clear-cell tumor of lung) Serum VEGF-D biomarker

4 Spontaneous Pneumothorax Chylous Effusion Serum VEGF-D-1885 pg/ml! Angiomyolipomas Retroperitoneal LAM Immune mediated (type 3 and 4) inflammatory response to a variety of inhaled antigens Labs: serum precipitating Ab, BAL lymphocyte predominant (>50%) with CD4/CD8 >1. Pathology: Subacute bronchiolocentric lymphocyte predominant interstitial infiltrate with poorly formed noncaseating granulomas. Areas of NSIP, organizing pneumonia and obliterative bronchiolitis may be present. Chronic findings of subacute HP + fibrosis 63

5 Mosaic ground glass and/or centrilobular nodules Irregular linear opacities patchy or peribronchovascular distribution Air trapping (key feature) Emphysema Lung cysts (13-30%)* Honeycombing (16-69%), mild Franquet T et al. JCAT 2003; 27: Case courtesy of Dr. J Kanne, University of Wisconsin Spectrum of benign lymphoproliferative disorders Diffuse interstitial infiltrate of small lymphocytes and plasma cells along airways and interstitium (BALT) Associations: Sjogren s Disease (most commonly) risk of NHL (44x) Chronic infection Collagen vascular disease (RA) Familial immunodeficiency, AIDS Hypersensitivity reaction. Poorly defined centrilobular or peribronchial nodules (3-12 mm). Ground glass opacities Septal thickening* Thickened peribronchovascular interstitium Perivascular cysts* usually involving <10% of lung parenchyma Mosaic air trapping * Cysts non-reversible 64

6 Amyloidosis Light Chain Deposition Disease Pulmonary nodules (SPN 60%, Ca++ 29%) Interlobular septal thickening Honeycombing Ground glass opacity Lymphadenopathy Lung cysts (rare and often in association with LIP and Sjogren s disease*) *Jeong YJ et al. JCAT 2004; 28:

7 Rare (report of 3 cases) Young women without renal involvement Progressive obstructive respiratory failure Dominant B cell clone restricted to the lung May be an antigen driven primary pulmonary lymphoproliferative process Colombat M et al. Blood 2008; 112: AD mutation at gene locus 17p11.2 encodes for folliculin, a tumor suppressor protein Clinical manifestations: Fibrofolliculomas over the face, neck, upper trunk Multiple lung cysts Renal tumors benign oncocytomas to renal cell carcinomas (multifocal or bilateral) colonic polyposis chorioretinal disease Lung cysts reported in > 80% Pathologically the cysts are associated with the peripheral interlobular septa, visceral pleura or septo-pleural junction HRCT findings: Cysts (often large) with normal intervening lung parenchyma Basilar* subpleural predominance Cysts abutting or including the proximal portions of the lower PA or PV Cysts involve less than 30% of lung 66

8 32x increased risk of PTX! Reported in leiomyosarcoma, synovial cell sarcoma, and endometrial stromal cell sarcoma (ESS), angiosarcoma. Patients may present acutely with spontaneous pneumothorax. Metastatic sarcomas tend to be located focally in the lung periphery not associated with the lymphatics (HMB45 and CD34 immunostains typically negative) Excavation of a centrally necrotic tumor nodule Infiltration of the walls of a pre-existing bulla Ball valve effect of tumor on bronchi with distension of alveoli and small airways Tumor cell proliferation to form vascular cystic spaces (angiosarcoma) 67

9 Diagnosis % Cysts Clinical Distinct HRCT Features Associations Langerhans Cell Histiocytosis S LAM TSC-LAM 100 Smoker Early centrilobular nodules, CP angle sparing 100 Pre menopausal women Seizures, skin lesions Diffuse uniform cysts, chylous effusions, Chronic HP Nonsmoker,exposure Cysts with GGO FB/LIP Sjogren s syndrome, CVD, AIDS Amyloidosis LCDD Birt-Hogg-Dube Syndrome Cystic Metastases Rare Often in Sjogren s Young women Perivascular cysts Rare nodules (Ca+ +) and cysts >80 Skin lesions Basilar, subpleural lentiform cysts Rare Hx of malignancy CA 125+ Peripheral, hematogenous Pulmonary hypertension Serum VEGF- D, AML Lymphoproliferative disorders Renal failure Renal neoplasms LCH is a cystic lung disease in smokers at end stage may mimic emphysema TSC-LAM and B-H-D syndrome are both associated with skin, lung and renal lesions LIP cysts are perivascular Amyloidosis/LCDD consider in a patient with renal failure with calcified and noncalcified nodules and cystic lung disease. Copley SJ et al. Lung morphology in the elderly: comparative CT study of subjects over 75 years old versus those under 55 years old. Radiology 2009; 251: Abbott GF et al. From the archives of the AFIP: pulmonary Langerhans cell histiocytosis. Radiographics 2004; 24: Abbott GF et al. From the archives of the AFIP: lumphangioleiomyomatasis: radiologic-pathologic correlation. Radiographics 2005; 25: Franquet T et al. Lung cysts in subacute hypersensitivity pneumonitis. J Comput Assist Tomogr 2003; 27: Jeong YJ et al. Amylooidosis and Lymphoproliferative Disease in Sjogren syndrome. J Comput Assist Tomogr 2004; 28: Colombat M et al. Pathomechanisms of cyst formation in pulmonary light chain deposition disease. Eur Respir J 2008; 32: Tobino K et al. Characteristics of pulmonary cysts in Birt Hogg Dube syndrome: Thin-section CT findings of the chest in 12 patients. Eur J Radiol

Diffuse Cystic Lung Disease at High-Resolution CT

Diffuse Cystic Lung Disease at High-Resolution CT Cardiopulmonary Imaging Pictorial Essay Seaman et al. HRCT of Diffuse Cystic Lung Disease Cardiopulmonary Imaging Pictorial Essay Downloaded from www.ajronline.org by 37.44.193.85 on 01/05/18 from IP address

More information

Spectrum of Cystic Lung Disease and its Mimics. Kathleen Jacobs MD and Elizabeth Weihe MD UC San Diego Medical Center, Department of Radiology

Spectrum of Cystic Lung Disease and its Mimics. Kathleen Jacobs MD and Elizabeth Weihe MD UC San Diego Medical Center, Department of Radiology Spectrum of Cystic Lung Disease and its Mimics Kathleen Jacobs MD and Elizabeth Weihe MD UC San Diego Medical Center, Department of Radiology No Financial Disclosures Learning Objectives 1. Review the

More information

Cystic lung diseases 7/21/2017. Cystic Lung Diseases. CT definition of a lung cyst. Important clinical clues

Cystic lung diseases 7/21/2017. Cystic Lung Diseases. CT definition of a lung cyst. Important clinical clues Cystic Lung Diseases Cystic lung diseases Aurelie Fabre Increased Awareness Spontaneous Pneumothorax High resolution imaging (HRCT) Multidisciplinary approach like interstitial lung disease CT definition

More information

Radiologic Approach to Smoking Related Interstitial Lung Disease

Radiologic 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 information

Outline Definition of Terms: Lexicon. Traction Bronchiectasis

Outline 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 information

Acute and Chronic Lung Disease

Acute 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 information

Systemic lupus erythematosus (SLE): Pleuropulmonary Manifestations

Systemic 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 information

An Image Repository for Chest CT

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 information

Hypersensitivity Pneumonitis: Spectrum of High-Resolution CT and Pathologic Findings

Hypersensitivity 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 information

A 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 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 information

Non-neoplastic Lung Disease II

Non-neoplastic Lung Disease II Pathobasic Non-neoplastic Lung Disease II Spasenija Savic Prince Pathology Program Systematic approach to surgical lung biopsies with ILD Examples (chronic ILD): Idiopathic interstitial pneumonias: UIP,

More information

Micronodular lung pattern - Differential diagnosis

Micronodular lung pattern - Differential diagnosis Micronodular lung pattern - Differential diagnosis Poster No.: P-0074 Congress: ESTI 2015 Type: Educational Poster Authors: P. Ninitas, F. Marinho, P. Campos, I. Távora ; Lisbon/PT, 1 2 2 3 1 1 3 Funchal/PT,

More information

10/17/2016. Nuts and Bolts of Thoracic Radiology. Objectives. Techniques

10/17/2016. 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 information

Thoracic lung involvement in rheumatoid arthritis: Findings on HRCT

Thoracic 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 information

ARTICLE IN PRESS. Ahuva Grubstein a, Daniele Bendayan b, Ithak Schactman c, Maya Cohen a, David Shitrit b, Mordechai R. Kramer b,

ARTICLE 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 information

Diffuse Interstitial Lung Diseases: Is There Really Anything New?

Diffuse Interstitial Lung Diseases: Is There Really Anything New? : Is There Really Anything New? Sujal R. Desai, MBBS, MD ESTI SPEAKER SUNDAY Society of Thoracic Radiology San Antonio, Texas March 2014 Diffuse Interstitial Lung Disease The State of Play DILDs Is There

More information

Cystic 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 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 information

Mimics in chest disease: interstitial opacities

Mimics 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 information

Epidemiology and classification of smoking related interstitial lung diseases

Epidemiology and classification of smoking related interstitial lung diseases Epidemiology and classification of smoking related interstitial lung diseases Šterclová M. Department of Respiratory Diseases, Thomayer Hospital, Prague, Czech Republic Supported by an IGA Grant No G 1207

More information

Diagnosis of TB: Radiology David Finlay, MD

Diagnosis 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 information

Pathologic Assessment of Interstitial Lung Disease

Pathologic Assessment of Interstitial Lung Disease Pathologic Assessment of Interstitial Lung Disease Dry and itchy? It could be eczema or fungal infection. We don t need to worry, the drugs aren t that dangerous. Kirk D. Jones, MD UCSF Dept. of Pathology

More information

Idiopathic Pulmonary Fibrosis: Spectrum of High-Resolution CT Findings

Idiopathic Pulmonary Fibrosis: Spectrum of High-Resolution CT Findings Idiopathic Pulmonary Fibrosis on CT Chest Imaging Pictorial Essay Carolina lthoff Souza 1 Nestor L. Müller 1 Julia Flint 2 Joanne L. Wright 2 ndrew Churg 2 Souza C, Müller NL, Flint J, Wright JL, Churg

More information

Diagnostic Imaging of Diffuse Infiltrative Disease of the Lung

Diagnostic 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 information

4/17/2010 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

4/17/2010 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 information

Cystic Lung Diseases: Spectrum of Radiologic Findings

Cystic Lung Diseases: Spectrum of Radiologic Findings Cystic Lung Diseases: Spectrum of Radiologic Findings Poster No.: P-0012 Congress: ESTI 2014 Type: Educational Poster Authors: B. Alami, O. Addou, M. Jaffal, Y. Lamrani, M. Boubbou, I. Kamaoui, M. Maaroufi,

More information

A Radiologist s Approach

A Radiologist s Approach November 2003 Respiratory Symptoms in HIV+ Patients: A Radiologist s Approach MaryCatherine Arbour, Harvard Medical School Year III Pulmonary Manifestations of HIV Neoplasms Lung CA Lymphoma Kaposi s sarcoma

More information

Challenges in the Diagnosis of Interstitial Lung Disease

Challenges in the Diagnosis of Interstitial Lung Disease Challenges in the Diagnosis of Interstitial Lung Disease Kirk D. Jones, MD UCSF Dept. of Pathology kirk.jones@ucsf.edu Overview New Classification of IIP Prior classification Modifications for new classification

More information

Interesting Cases. Pulmonary

Interesting 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 information

OFF THE BEATEN TRACK: A Pictorial Review of Atypical Features of Pulmonary Metastases

OFF THE BEATEN TRACK: A Pictorial Review of Atypical Features of Pulmonary Metastases OFF THE BEATEN TRACK: A Pictorial Review of Atypical Features of Pulmonary Metastases Megan Hora, MD Chi Wan Koo, MD Christian Cox, MD Department of Diagnostic Radiology Thoracic Imaging Section Mayo Clinic

More information

Multiple Cystlike Lung Lesions

Multiple Cystlike Lung Lesions Residents Section Pattern of the Month Cantin et al. Multiple Cystlike Lung Lesions in the dult Residents Section Pattern of the Month Residents inradiology Luce Cantin 1 lexander. ankier Ronald L. Eisenberg

More information

INTERSTITIAL 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 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 information

Progress in Idiopathic Pulmonary Fibrosis

Progress 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 information

Replacement of air with fluid, inflammatory. cells or cellular debris. Parenchymal, Interstitial (Restrictive) and Vascular Diseases.

Replacement 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 information

Imaging Cancer Treatment Complications in the Chest

Imaging Cancer Treatment Complications in the Chest Imaging Cancer Treatment Complications in the Chest Michelle S. Ginsberg, MD Objectives Imaging Cancer Treatment Complications in the Chest To understand the mechanisms of action of different classes of

More information

CAVITATING LUNG NODULES AND PNEUMO- THORAX IN CHILDREN WITH METASTATIC WILMS TUMOR*

CAVITATING LUNG NODULES AND PNEUMO- THORAX IN CHILDREN WITH METASTATIC WILMS TUMOR* APRIL, 1976 ABSTRACT: CAVITATING LUNG NODULES AND PNEUMO- THORAX IN CHILDREN WITH METASTATIC WILMS TUMOR* By E. GEORGE KASSNER, M.D.,t HAROLD S. GOLDMAN, M.D.4 and ALBERTO ELGUEZABAL, M.D. BRONX AND BROOKLYN,

More information

LAM 101. Lymph-angio-leiomyo-matosis

LAM 101. Lymph-angio-leiomyo-matosis LAM 101 Lymph-angio-leiomyo-matosis Charlie Strange, MD Division of Pulmonary and Critical Care Medicine Medical University of South Carolina Dr. Strange has been a grant recipient in LAM from the NIH,

More information

COPD in Radiology, with a Focus on Bronchiectasis and Emphysema

COPD in Radiology, with a Focus on Bronchiectasis and Emphysema November, 2002 COPD in Radiology, with a Focus on Bronchiectasis and Emphysema Evan Lyon, Harvard Medical School, Year IV Course Director Why is COPD important? Its common: 30 million Americans living

More information

Interstitial Lung Disease in Infants and Children

Interstitial Lung Disease in Infants and Children Interstitial Lung Disease in Infants and Children David A. Mong, MD SUNDAY Andrew Mong MD Beyond the interstitium (path includes airways/airspace) Radiographic diffuse disease Adult Interstitial Lung Disease

More information

Introduction to Radiology for TB Nurses

Introduction to Radiology for TB Nurses Introduction to Radiology for TB Nurses Juzar Ali, MD; FRCP(C); FCCP May 4, 2018 Essential Skills for the TB Nurse Case Manager Little Rock, AR May 3 4, 2017 Juzar Ali, MD; FRCP(C); FCCP has the following

More information

ACUTE 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 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 information

Extraordinary Patterns of Tuberculosis

Extraordinary Patterns of Tuberculosis Extraordinary Patterns of Tuberculosis E. Kadakovska Infectology Center of Latvia, Clinic of Tuberculosis and Lung Diseases, Diagnostics and Radiology Department 1 Target Importance of recognizing of tuberculosis

More information

Tuberculosis: The Essentials

Tuberculosis: 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 information

Noninfectious Inflammatory Lung Disease: Imaging Considerations and Clues to Differential Diagnosis

Noninfectious Inflammatory Lung Disease: Imaging Considerations and Clues to Differential Diagnosis Cardiopulmonary Imaging Review Nemec et al. Noninfectious Inflammatory Lung Disease Cardiopulmonary Imaging Review Stefan Franz Nemec 1 Ronald L. Eisenberg Alexander A. Bankier Nemec SF, Eisenberg RL,

More information

From the Archives of the AFIP

From the Archives of the AFIP AFIP ARCHIVES 821 CME FEATURE See accompanying test at http:// www.rsna.org /education /rg_cme.html LEARNING OBJECTIVES FOR TEST 6 After reading this article and taking the test, the reader will be able

More information

Imaging findings of thoracic cavitating and cystic lesions

Imaging findings of thoracic cavitating and cystic lesions Imaging findings of thoracic cavitating and cystic lesions Yoshiyuki Ozawa 1 Masaki Hara 2 Motoo Nakagawa 1 Tomoya Sekiguchi 1 Yuta Shibamoto 1 1) Department of Radiology, Nagoya City University Graduate

More information

Diagnostic Approach to Advanced Fibrotic Interstitial Lung Disease. Bringing Together Clinical, Radiologic, and Histologic Clues

Diagnostic Approach to Advanced Fibrotic Interstitial Lung Disease. Bringing Together Clinical, Radiologic, and Histologic Clues Diagnostic Approach to Advanced Fibrotic Interstitial Lung Disease Bringing Together Clinical, Radiologic, and Histologic Clues Brandon T. Larsen, MD, PhD; Maxwell L. Smith, MD; Brett M. Elicker, MD; Jessica

More information

Pulmonary Nodules & Masses

Pulmonary Nodules & Masses Pulmonary Nodules & Masses A Diagnostic Approach Heber MacMahon The University of Chicago Department of Radiology Disclosure Information Consultant for Riverain Technology Minor equity in Hologic Royalties

More information

Pneumocystis jiroveci Pneumonia: High-Resolution CT Findings in Patients With and Without HIV Infection

Pneumocystis 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 information

Idiopathic Pulmonary of Care

Idiopathic Pulmonary of Care Chapter 6.1 Living Medical etextbook A Digital Tool at the Point of Care From Projects In Knowledge Pulmonology Idiopathic Pulmonary Fibrosis @Point of Care IPF Case Study: Typical Presentation, Role of

More information

MANAGEMENT RECOMMENDATIONS

MANAGEMENT RECOMMENDATIONS 1 MANAGEMENT RECOMMENDATIONS 1. Adrenal masses!!!!!!! page 2 2. Liver Masses!!!!!!! page 3 3. Obstetric US Soft Markers for Aneuploidy!! pages 4-6 4. Ovarian and Adnexal Cysts!!!!! pages 7-10 5. Pancreatic

More information

Multi Detector Row CT and Postprocessing Techniques in the Assessment of Diffuse Lung Disease 1

Multi Detector Row CT and Postprocessing Techniques in the Assessment of Diffuse Lung Disease 1 EDUCATION EXHIBIT 1639 Multi Detector Row CT and Postprocessing Techniques in the Assessment of Diffuse Lung Disease 1 Catherine Beigelman-Aubry, MD Catherine Hill, FRCR Aymeric Guibal, MD Julien Savatovsky,

More information

Alveolar "lepidic" pulmonary metastases: imaging findings and pathologic correlation.

Alveolar lepidic pulmonary metastases: imaging findings and pathologic correlation. Alveolar "lepidic" pulmonary metastases: imaging findings and pathologic correlation. Poster No.: C-0733 Congress: ECR 2016 Type: Educational Exhibit Authors: F. Zuccarino, Á. Gayete Cara, F. Fernandez

More information

Thoracic CT pattern in lung cancer: correlation of CT and pathologic diagnosis

Thoracic 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 information

A Japanese Family with Multiple Lung Cysts and Recurrent Pneumothorax: A Possibility of Birt-Hogg-Dubé Syndrome

A Japanese Family with Multiple Lung Cysts and Recurrent Pneumothorax: A Possibility of Birt-Hogg-Dubé Syndrome CASE REPORT A Japanese Family with Multiple Lung Cysts and Recurrent Pneumothorax: A Possibility of Birt-Hogg-Dubé Syndrome Hiroshi Ishii 1, Hiroaki Oka 1, Yuka Amemiya 1, Atsuko Iwata 1, Satoshi Otani

More information

Respiratory Interactive Session. Elaine Borg

Respiratory 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 information

Radiologic findings of drug-induced lung disease

Radiologic 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 information

Pulmonary Microvascular Disease

Pulmonary Microvascular Disease Pulmonary Microvascular Disease CS Restrepo M.D. (UT Health San Antonio, TX) D. Vargas M.D. (University of Colorado in Denver, CO) Saboo M.D. (UT Southwestern, Dallas TX) A.J. Baxi M.D. (UT Health San

More information

Radiological features of idiopathic interstitial pneumonia: a pictorial review

Radiological features of idiopathic interstitial pneumonia: a pictorial review Radiological features of idiopathic interstitial pneumonia: a pictorial review Poster No.: C-2012 Congress: ECR 2013 Type: Educational Exhibit Authors: M. Piccoli, F. Roccasalva, S. Palmucci, G. Cappello,

More information

Bronchial involvement in chronic eosinophilic pneumonia: a case report

Bronchial involvement in chronic eosinophilic pneumonia: a case report Case Report Bronchial involvement in chronic eosinophilic pneumonia: a case report Na Hee Kim 1, Kyung Hee Lee 1, Jun Ho Kim 1, Jae Hwa Cho 2, Lucia Kim 3, Eugene Kim 1 1 Department of Radiology, Inha

More information

Lung CT: Part 2, The Interstitial Pneumonias Clinical, Histologic, and CT Manifestations

Lung 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 information

Mesothelioma: diagnostic challenges from a pathological perspective. Naseema Vorajee August 2016

Mesothelioma: diagnostic challenges from a pathological perspective. Naseema Vorajee August 2016 Mesothelioma: diagnostic challenges from a pathological perspective Naseema Vorajee August 2016 Naseema.vorajee@nhls.ac.za Pleural diseases (whether neoplastic, reactive or infective) may have similar

More information

A. Chachaj, K. Drozdz, M. Chabowski, P. Dziegiel, I. Grzegorek, A. Wojnar, P. Jazwiec, A. Szuba

A. Chachaj, K. Drozdz, M. Chabowski, P. Dziegiel, I. Grzegorek, A. Wojnar, P. Jazwiec, A. Szuba 53 Lymphology 45 (2012) 53-57 CHYLOPERITONEUM, CHYLOTHORAX AND LOWER EXTREMITY LYMPHEDEMA IN WOMAN WITH SPORADIC LYMPHANGIOLEIOMYOMATOSIS SUCCESSFULLY TREATED WITH SIROLIMUS: A CASE REPORT A. Chachaj,

More information

FDG PET/CT in Lung Cancer Read with the experts. Homer A. Macapinlac, M.D.

FDG PET/CT in Lung Cancer Read with the experts. Homer A. Macapinlac, M.D. FDG PET/CT in Lung Cancer Read with the experts Homer A. Macapinlac, M.D. Patient with suspected lung cancer presents with left sided chest pain T3 What is the T stage of this patient? A) T2a B) T2b C)

More information

RADIOLOGICALL ANALYSIS OF INTERSTITIAL LUNG DISEASES

RADIOLOGICALL ANALYSIS OF INTERSTITIAL LUNG DISEASES Original Research Article RADIOLOGICALL ANALYSIS OF INTERSTITIAL LUNG DISEASES Meraj Rentia 1*, Himanshu Singla 1, Divya Malpani 2, Tushar Vaishnav 3, Pradeep Jhala 3 1 1 st year Resident, 2 3 rd year

More information

3/28/2017. Disclosure of Relevant Financial Relationships. Disclosure of Relevant Financial Relationships. Disclosure of Off-Label Use

3/28/2017. Disclosure of Relevant Financial Relationships. Disclosure of Relevant Financial Relationships. Disclosure of Off-Label Use Cardiovascular Pathology Evening Specialty Conference Case #2 Brandon T. Larsen, MD, PhD Senior Associate Consultant and Assistant Professor Department of Laboratory Medicine and Pathology Mayo Clinic

More information

Low-dose CT Lung Cancer Screening Guidelines for Pulmonary Nodules Management Version 2

Low-dose CT Lung Cancer Screening Guidelines for Pulmonary Nodules Management Version 2 Low-dose CT Lung Cancer Screening Guidelines for Pulmonary Nodules Management Version 2 The Committee for Management of CT-screening-detected Pulmonary Nodules 2009-2011 The Japanese Society of CT Screening

More information

The changing face of a rare disease: LAM

The changing face of a rare disease: LAM The changing face of a rare disease: LAM Olga Torre U.O. di Pneumologia e UTIR Servizio di Emodinamica e Fisiopatologia Respiratoria Ospedale San Giuseppe - Milano 6 th International Congress on Rare Pulmonary

More information

The Respiratory System

The Respiratory System The Respiratory System Respiratory Anatomy Upper respiratory tract Nose Nasal passages Pharynx Larynx Respiratory Anatomy Functions of the upper respiratory tract: Provide entry for inhaled air Respiratory

More information

pulmonary and critical care pearls

pulmonary and critical care pearls pulmonary and critical care pearls A 12-Year-Old Girl With Dyspnea and a Normal Chest Radiographic Finding* Kristin B. Highland, MD; and Patrick A. Flume, MD, FCCP (CHEST 2001; 120:1372 1376) A 12-year-old

More information

Residents Section Pattern of the Month

Residents 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 information

Interstitial Lung Disease. Camille Washowich, MSN, ACNP, CCRN Center for Advanced Lung Disease Stanford University Medical Center

Interstitial Lung Disease. Camille Washowich, MSN, ACNP, CCRN Center for Advanced Lung Disease Stanford University Medical Center Interstitial Lung Disease Camille Washowich, MSN, ACNP, CCRN Center for Advanced Lung Disease Stanford University Medical Center Lung Physiology ILD Classification Interstitial Lung Disease Connective

More information

TBLB is not recommended as the initial biopsy option in cases of suspected IPF and is unreliable in the diagnosis of rare lung disease (other than

TBLB is not recommended as the initial biopsy option in cases of suspected IPF and is unreliable in the diagnosis of rare lung disease (other than TBLB is not recommended as the initial biopsy option in cases of suspected IPF and is unreliable in the diagnosis of rare lung disease (other than PAP) BAL is not required as a diagnostic tool in patients

More information

INDEX. surgpath.theclinics.com. Note: Page numbers of article titles are in boldface type. diffuse pleural fibrosis, pleural plaques,

INDEX. surgpath.theclinics.com. Note: Page numbers of article titles are in boldface type. diffuse pleural fibrosis, pleural plaques, INDEX Note: Page numbers of article titles are in boldface type. A Adenocarcinoma, minimally invasive. See Minimally invasive adenocarcinoma (MIA). Airway-centered interstitial fibrosis, 183 184 ALK (anaplastic

More information

CT in Idiopathic Pulmonary Fibrosis: Diagnosis and Beyond

CT 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 information

Radiological Aspects of Pulmonary Tuberculosis in Immunocompetent Hosts

Radiological Aspects of Pulmonary Tuberculosis in Immunocompetent Hosts Nov 2003 Radiological Aspects of Pulmonary Tuberculosis in Immunocompetent Hosts Josh Rempell, Harvard Medical School Year III Tuberculosis: the captain of all (wo)men of death Overall, one third of the

More information

Chest XRay interpretation INTERPRETATIONS Identifications: Name & Date Technical evaluation Basic Interpretations

Chest 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 information

Radiology Pathology Conference

Radiology Pathology Conference Radiology Pathology Conference Sharlin Johnykutty,, MD, Cytopathology Fellow Sara Majewski, MD, Radiology Resident Friday, August 28, 2009 Presentation material is for education purposes only. All rights

More information

Diseases 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 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 information

Update on ChILD. R. Paul Guillerman, MD Associate Professor Department of Pediatric Radiology

Update on ChILD. R. Paul Guillerman, MD Associate Professor Department of Pediatric Radiology Update on ChILD R. Paul Guillerman, MD Associate Professor Department of Pediatric Radiology Objectives Review recent advances in the imaging of childhood interstitial lung disease (ChILD) Diseases under-recognized,

More information

Radiological Manifestations of Common Variable Immuodeficiency Sydrome (CVID) and associated complications

Radiological Manifestations of Common Variable Immuodeficiency Sydrome (CVID) and associated complications Radiological Manifestations of Common Variable Immuodeficiency Sydrome (CVID) and associated complications Poster No.: P-0034 Congress: ESTI 2014 Type: Educational Poster Authors: A. Wallis, C. Ball, K.

More information

Pleuropulmonary Blastoma

Pleuropulmonary Blastoma CHAPTER 2 Pleuropulmonary Blastoma Megan K. Dishop A lthough rare, pleuropulmonary blastoma (PPB) is the most common primary malignancy of the lung parenchyma in children. PPB has a spectrum of gross and

More information

Interstitial Lung Diseases(ILD) By : Dr. Shaher M. Samrah Done by : Ibrahim M. sun

Interstitial Lung Diseases(ILD) By : Dr. Shaher M. Samrah Done by : Ibrahim M. sun Interstitial Lung Diseases(ILD) By : Dr. Shaher M. Samrah Done by : Ibrahim M. sun. 26.11.11 Introduction Interstitial Lung Diseases (ILD) are group of diseases that affect the interstitium of the lungs,

More information

Pulmonary features of Birt-Hogg-Dubé syndrome: Cystic lesions and pulmonary histiocytoma

Pulmonary features of Birt-Hogg-Dubé syndrome: Cystic lesions and pulmonary histiocytoma Respiratory Medicine (2011) 105, 768e774 available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/rmed Pulmonary features of Birt-Hogg-Dubé syndrome: Cystic lesions and pulmonary histiocytoma

More information

A CASE OF UNFORTUNATE

A CASE OF UNFORTUNATE A CASE OF UNFORTUNATE TAPER Hélène Schoemans, MD University Hospitals Leuven, Belgium EBMT Complications and Quality of Life Working Party Educational Course Warsaw, October 24 th 2014 Company name No

More information

Case Report pissn / eissn J Korean Soc Radiol 2016;75(2):

Case Report pissn / eissn J Korean Soc Radiol 2016;75(2): Case Report pissn 1738-2637 / eissn 2288-2928 http://dx.doi.org/10.3348/jksr.2016.75.2.151 Thoracic Air-Leakage Syndrome in Allogeneic Stem Cell Transplant Recipients as a Late Complication of Chronic

More information

Lung. 10/24/13 Chest X-ray: 2.9 cm mass like density in the inferior lingular segment worrisome for neoplasm. Malignancy cannot be excluded.

Lung. 10/24/13 Chest X-ray: 2.9 cm mass like density in the inferior lingular segment worrisome for neoplasm. Malignancy cannot be excluded. Lung Case Scenario 1 A 54 year white male presents with a recent abnormal CT of the chest. The patient has a history of melanoma, kidney, and prostate cancers. 10/24/13 Chest X-ray: 2.9 cm mass like density

More information

Nontuberculous Mycobacterial Lung Disease

Nontuberculous Mycobacterial Lung Disease Non-TB Mycobacterial Disease Jeffrey P. Kanne, MD Nontuberculous Mycobacterial Lung Disease Jeffrey P. Kanne, M.D. Consultant Disclosures Perceptive Informatics Royalties (book author) Amirsys, Inc. Wolters

More information

Journal of Radiology Case Reports

Journal of Radiology Case Reports Pulmonary Alveolar Microlithiasis - Clinico-Radiological dissociation - Sanjay Mhalasakant Khaladkar 1*, Sushen kumar Kondapavuluri 1, Anubhav Kamal 1, Raghav Kalra 1, Rajesh Kuber 1 1. Department of Radiodiagnosis,

More information

Key words: CT scanners; interstitial lung diseases; polymyositis-dermatomyositis; x-ray

Key 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 information

Pulmonary Aspergillosis

Pulmonary Aspergillosis May 2005 Pulmonary Aspergillosis Nancy Wei, Harvard Medical School, Year III Overview Pulmonary aspergillosis background information Patient presentations Common radiographic findings for each type of

More information

Pulmonary Sarcoidosis: Typical and Atypical Manifestations at High- Resolution CT with Pathologic Correlation 1

Pulmonary Sarcoidosis: Typical and Atypical Manifestations at High- Resolution CT with Pathologic Correlation 1 Note: This copy is for your personal non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, contact us at www.rsna.org/rsnarights. CHEST IMAGING Pulmonary

More information

Cryptogenic Organizing Pneumonia: Serial High-Resolution CT Findings in 22 Patients

Cryptogenic 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 information

Various hereditary, acquired and neoplastic conditions can lead to cyst formation in the kidney.

Various hereditary, acquired and neoplastic conditions can lead to cyst formation in the kidney. Dr. Fatima AlAl-Hashimi Hashimi,, MD, FRCPath Salmaniya Medical Complex, Bahrain Various hereditary, acquired and neoplastic conditions can lead to cyst formation in the kidney. The most frequently encountered

More information

Fisiopatologia, linee guida e pratica quotidiana

Fisiopatologia, linee guida e pratica quotidiana BPCO Fisiopatologia, linee guida e pratica quotidiana Antonella Caminati U.O. di Pneumologia e UTIR Servizio di Emodinamica e Fisiopatologia Respiratoria Ospedale San Giuseppe - MultiMedica IRCCS Milano

More information

Chest X-ray Interpretation

Chest 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 information

The role of medical thoracoscopy in primary spontaneous pneumothorax (PSP)

The role of medical thoracoscopy in primary spontaneous pneumothorax (PSP) Medical School of Alexandroupolis Democritus University of Thrace The role of medical thoracoscopy in primary spontaneous pneumothorax (PSP) Prof. Marios Froudarakis, MD, PhD, Head, Department of Pneumonology

More information

Multidisciplinary Diagnosis in Action: Challenging Case Presentations

Multidisciplinary Diagnosis in Action: Challenging Case Presentations Multidisciplinary Diagnosis in Action: Challenging Case Presentations Interstitial Lung Disease: Advances in Diagnosis and Management UCSF CME November 8, 2014 Case 1 69 yo M 3 year history of intermittent

More information

Silicoproteinosis: High-Resolution CT Findings in 13 Patients

Silicoproteinosis: 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 information

Interstitial Lung Disease. SS Visser, Lung Unit, UP.

Interstitial Lung Disease. SS Visser, Lung Unit, UP. Interstitial Lung Disease SS Visser, Lung Unit, UP. ILD - Definition Heterogenous group of diseases with involvement of alveolar walls and peri- alveolar tissue -nonmalignant, non-infective. ± 180 diseases

More information