Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0019
Christopher M Walker
The chapter titled subsegmental and rounded atelectasis discusses the radiographic and computed tomography (CT) appearances of subsegmental and rounded atelectasis. Subsegmental atelectasis is linear or platelike atelectasis confined to a single subsegment or extending across multiple subsegments of lung. It is seen in a variety of pulmonary and abdominal conditions including prolonged shallow breathing, pulmonary thromboembolic disease, diaphragmatic dysfunction, and pneumonia. Rounded atelectasis is folded or collapsed lung that develops adjacent to an area of pleural thickening, fibrosis, or effusion. There are several imaging features that must be present before confidently diagnosing rounded atelectasis including significant contact with adjacent pleural abnormality, signs of volume loss, acute angles with the pleura, and the comet tail sign. If these criteria are met, CT followup is sufficient in most cases.
{"title":"Subsegmental and Rounded Atelectasis","authors":"Christopher M Walker","doi":"10.1093/MED/9780199858064.003.0019","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0019","url":null,"abstract":"The chapter titled subsegmental and rounded atelectasis discusses the radiographic and computed tomography (CT) appearances of subsegmental and rounded atelectasis. Subsegmental atelectasis is linear or platelike atelectasis confined to a single subsegment or extending across multiple subsegments of lung. It is seen in a variety of pulmonary and abdominal conditions including prolonged shallow breathing, pulmonary thromboembolic disease, diaphragmatic dysfunction, and pneumonia. Rounded atelectasis is folded or collapsed lung that develops adjacent to an area of pleural thickening, fibrosis, or effusion. There are several imaging features that must be present before confidently diagnosing rounded atelectasis including significant contact with adjacent pleural abnormality, signs of volume loss, acute angles with the pleura, and the comet tail sign. If these criteria are met, CT followup is sufficient in most cases.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"519 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134287013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/med/9780199858064.003.0002
M. Rosado-de-Christenson
The chapter titled imaging modalities describes various methods of imaging the thorax. Imaging of patients presenting with thoracic complaints typically begins with chest radiography. Ambulatory patients should undergo posteroanterior (PA) and lateral chest radiographs. Anteroposterior (AP) chest radiography should be reserved for debilitated, critically ill and traumatized patients. Special chest radiographic projections such as decubitus chest radiography may be employed for specific indications. Chest CT is the imaging study of choice for evaluating most abnormalities found on radiography. Contrast-enhanced chest CT is optimal for evaluation of vascular abnormalities, the hila and some mediastinal lesions. CT angiography is routinely employed in patients with suspected pulmonary thromboembolism or acute aortic syndromes. High-resolution chest CT is reserved for the evaluation of diffuse infiltrative lung disease and often includes expiratory and prone imaging. FDG PET/CT is increasingly employed in the assessment of patients with malignancy for the purposes of initial staging and post therapy re-staging of affected patients. Ventilation/perfusion scintigraphy is used in the assessment of pulmonary thromboembolism. Additional thoracic imaging techniques include: Fluoroscopy for evaluation of the diaphragm, and ultrasound for evaluation of the thyroid and the pleural space.
{"title":"Imaging Modalities","authors":"M. Rosado-de-Christenson","doi":"10.1093/med/9780199858064.003.0002","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0002","url":null,"abstract":"The chapter titled imaging modalities describes various methods of imaging the thorax. Imaging of patients presenting with thoracic complaints typically begins with chest radiography. Ambulatory patients should undergo posteroanterior (PA) and lateral chest radiographs. Anteroposterior (AP) chest radiography should be reserved for debilitated, critically ill and traumatized patients. Special chest radiographic projections such as decubitus chest radiography may be employed for specific indications. Chest CT is the imaging study of choice for evaluating most abnormalities found on radiography. Contrast-enhanced chest CT is optimal for evaluation of vascular abnormalities, the hila and some mediastinal lesions. CT angiography is routinely employed in patients with suspected pulmonary thromboembolism or acute aortic syndromes. High-resolution chest CT is reserved for the evaluation of diffuse infiltrative lung disease and often includes expiratory and prone imaging. FDG PET/CT is increasingly employed in the assessment of patients with malignancy for the purposes of initial staging and post therapy re-staging of affected patients. Ventilation/perfusion scintigraphy is used in the assessment of pulmonary thromboembolism. Additional thoracic imaging techniques include: Fluoroscopy for evaluation of the diaphragm, and ultrasound for evaluation of the thyroid and the pleural space.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133350792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0037
S. Betancourt
Opportunistic fungal infections are caused by fungi that are nonpathogenic in the immunocompetent host, many of which are part of the normal upper respiratory tract flora. These organisms may cause pulmonary infection in immunocompromised hosts. Immunocompromised patients and patients with febrile neutropenia with opportunistic fungal infections may have normal chest radiographs. Thus, chest CT should be performed for further evaluation. Imaging abnormalities in this patient population should raise suspicion for opportunistic infection. Neutropenia is the single most important risk factor for Aspergillosis. Aspergillus is the most common opportunistic infection in patients with hematologic malignancy and bone marrow transplantation. Aspergillus spp., Candida spp., and Cryptococcus spp. are the most common fungal infections in patients with solid organ transplantation. Pneumocystis jirovecii is the most common fungal infection in patients AIDS with CD4 count s<200 cells/mm3. Cryptococcal pneumonia is also common in this population. There has been a recent increase in uncommon fungal pathogens causing invasive pulmonary disease.
{"title":"Opportunistic Fungal Infection","authors":"S. Betancourt","doi":"10.1093/MED/9780199858064.003.0037","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0037","url":null,"abstract":"Opportunistic fungal infections are caused by fungi that are nonpathogenic in the immunocompetent host, many of which are part of the normal upper respiratory tract flora. These organisms may cause pulmonary infection in immunocompromised hosts. Immunocompromised patients and patients with febrile neutropenia with opportunistic fungal infections may have normal chest radiographs. Thus, chest CT should be performed for further evaluation. Imaging abnormalities in this patient population should raise suspicion for opportunistic infection. Neutropenia is the single most important risk factor for Aspergillosis. Aspergillus is the most common opportunistic infection in patients with hematologic malignancy and bone marrow transplantation. Aspergillus spp., Candida spp., and Cryptococcus spp. are the most common fungal infections in patients with solid organ transplantation. Pneumocystis jirovecii is the most common fungal infection in patients AIDS with CD4 count s<200 cells/mm3. Cryptococcal pneumonia is also common in this population. There has been a recent increase in uncommon fungal pathogens causing invasive pulmonary disease.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130257159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/med/9780199858064.003.0035
S. Betancourt
Cavitation is low-attenuation or lucency within a consolidation, nodule, or mass. While infection is the most common etiology of cavitation, other entities should also be considered. Cavitation of nodules, masses or consolidations is often related to infection, but can also occur in septic embolism, vasculitides, and pulmonary infarction. Aspiration pneumonia may manifest with cavitation and is common in institutionalized patients with altered state of consciousness. Anaerobes and enterobacteria are common etiologic agents. Mycobacterium tuberculosis should always be considered in patients with upper lobe cavitary disease. These patients should be isolated until etiology is proven. Aspergillus spp, nocardia spp, and Pneumocystis jiroveci should be considered in immunocompromised patients. Staphylococcus aureus is the most common cause of septic emboli. In patients without clinical evidence of infection, granulomatosis with polyangiitis and metastatic disease should be considered.
{"title":"Cavitation","authors":"S. Betancourt","doi":"10.1093/med/9780199858064.003.0035","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0035","url":null,"abstract":"Cavitation is low-attenuation or lucency within a consolidation, nodule, or mass. While infection is the most common etiology of cavitation, other entities should also be considered. Cavitation of nodules, masses or consolidations is often related to infection, but can also occur in septic embolism, vasculitides, and pulmonary infarction. Aspiration pneumonia may manifest with cavitation and is common in institutionalized patients with altered state of consciousness. Anaerobes and enterobacteria are common etiologic agents. Mycobacterium tuberculosis should always be considered in patients with upper lobe cavitary disease. These patients should be isolated until etiology is proven. Aspergillus spp, nocardia spp, and Pneumocystis jiroveci should be considered in immunocompromised patients. Staphylococcus aureus is the most common cause of septic emboli. In patients without clinical evidence of infection, granulomatosis with polyangiitis and metastatic disease should be considered.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114621807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0046
R. Benson
The chapter titled Nodules and Masses discusses these frequent imaging manifestations of primary lung cancer. A lung nodule is a roughly spherical, circumscribed density that measures < 3 cm. A lung mass is larger than 3 cm. Lung cancer may manifest as a solitary pulmonary nodule or mass. Most solitary pulmonary nodules on radiographs are benign, and the majority represent granulomas and intrapulmonary lymph nodes. Larger lung nodules and lung masses are more likely to be malignant. Nodule assessment includes determination of size, morphology, attenuation, metabolic activity, enhancement characteristics and growth. A solid lung nodule that is stable for 2 years is generally presumed benign. Sub-solid (part-solid and ground-glass nodules) often represent indolent lung cancer, and different follow-up and management guidelines apply. Confident diagnosis of benign nodules such as granulomas is important, as these lesions do not require imaging follow-up.
{"title":"Lung Cancer: Nodules and Masses","authors":"R. Benson","doi":"10.1093/MED/9780199858064.003.0046","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0046","url":null,"abstract":"The chapter titled Nodules and Masses discusses these frequent imaging manifestations of primary lung cancer. A lung nodule is a roughly spherical, circumscribed density that measures < 3 cm. A lung mass is larger than 3 cm. Lung cancer may manifest as a solitary pulmonary nodule or mass. Most solitary pulmonary nodules on radiographs are benign, and the majority represent granulomas and intrapulmonary lymph nodes. Larger lung nodules and lung masses are more likely to be malignant. Nodule assessment includes determination of size, morphology, attenuation, metabolic activity, enhancement characteristics and growth. A solid lung nodule that is stable for 2 years is generally presumed benign. Sub-solid (part-solid and ground-glass nodules) often represent indolent lung cancer, and different follow-up and management guidelines apply. Confident diagnosis of benign nodules such as granulomas is important, as these lesions do not require imaging follow-up.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"107 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134214717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0031
Christopher M Walker
Pleural thickening and calcification discusses the radiographic and computed tomography (CT) manifestations of benign pleural thickening and pleural calcification. Benign pleural thickening must be differentiated from malignant pleural thickening and their differentiating characteristics will be discussed. Pleural plaque is the most common manifestation of asbestos exposure and carries no risk of malignant degeneration. The most common imaging appearance is bilateral sharply demarcated, multifocal areas of discontinuous pleural thickening that often calcifies over time. Pleural plaques spare the apical and costophrenic sulcus pleura and has a predilection for the diaphragmatic pleura. Diffuse pleural thickening is associated with hemothorax, empyema, connective tissue disorders, and asbestos exposure. It is generally unilateral, causes blunting of the costophrenic angle, spans multiple rib interspaces, and is irregular in shape. When diffuse pleural thickening calcifies and is associated with volume loss in the affected lung, it is termed fibrothorax.
{"title":"Pleural Thickening and Calcification","authors":"Christopher M Walker","doi":"10.1093/MED/9780199858064.003.0031","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0031","url":null,"abstract":"Pleural thickening and calcification discusses the radiographic and computed tomography (CT) manifestations of benign pleural thickening and pleural calcification. Benign pleural thickening must be differentiated from malignant pleural thickening and their differentiating characteristics will be discussed. Pleural plaque is the most common manifestation of asbestos exposure and carries no risk of malignant degeneration. The most common imaging appearance is bilateral sharply demarcated, multifocal areas of discontinuous pleural thickening that often calcifies over time. Pleural plaques spare the apical and costophrenic sulcus pleura and has a predilection for the diaphragmatic pleura. Diffuse pleural thickening is associated with hemothorax, empyema, connective tissue disorders, and asbestos exposure. It is generally unilateral, causes blunting of the costophrenic angle, spans multiple rib interspaces, and is irregular in shape. When diffuse pleural thickening calcifies and is associated with volume loss in the affected lung, it is termed fibrothorax.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134512408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0088
M. Rosado-de-Christenson
The introduction to developmental abnormalities summarizes the types of developmental thoracic anomalies and variants that may affect the adult patient. These abnormalities can be categorized based on their anatomic location within the thorax and may affect the airways, lung, pleura, mediastinum, heart, blood vessels, diaphragm and chest wall. Assessment of central tracheobronchial morphology is important in the determination of visceral-atrial situs. Airway anatomic variants are common but do not usually produce symptoms or require treatment. There is great variability in the fissural anatomy of the lung with frequent incomplete and accessory fissures. Intralobar sequestration may affect children, adolescents or adults and is confirmed by visualization of systemic blood supply to abnormal lung parenchyma. Developmental abnormalities may also affect the mediastinum and the cardiovascular system. Symptomatic patients may present in adulthood with intra- and extracardiac shunt lesions. Developmental lesions may also affect the systemic arteries and veins and may result in anomalous pulmonary venous return to the right heart. These lesions are typically evaluated with chest CT and/or MRI. Diaphragmatic developmental lesions in adults include Bochdalek and Morgagni hernias. Congenital anomalies may also affect the chest wall osseous structures and soft tissues.
{"title":"Introduction to Developmental Abnormalities","authors":"M. Rosado-de-Christenson","doi":"10.1093/MED/9780199858064.003.0088","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0088","url":null,"abstract":"The introduction to developmental abnormalities summarizes the types of developmental thoracic anomalies and variants that may affect the adult patient. These abnormalities can be categorized based on their anatomic location within the thorax and may affect the airways, lung, pleura, mediastinum, heart, blood vessels, diaphragm and chest wall. Assessment of central tracheobronchial morphology is important in the determination of visceral-atrial situs. Airway anatomic variants are common but do not usually produce symptoms or require treatment. There is great variability in the fissural anatomy of the lung with frequent incomplete and accessory fissures. Intralobar sequestration may affect children, adolescents or adults and is confirmed by visualization of systemic blood supply to abnormal lung parenchyma. Developmental abnormalities may also affect the mediastinum and the cardiovascular system. Symptomatic patients may present in adulthood with intra- and extracardiac shunt lesions. Developmental lesions may also affect the systemic arteries and veins and may result in anomalous pulmonary venous return to the right heart. These lesions are typically evaluated with chest CT and/or MRI. Diaphragmatic developmental lesions in adults include Bochdalek and Morgagni hernias. Congenital anomalies may also affect the chest wall osseous structures and soft tissues.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132961784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0041
S. Martinez-Jiménez
Evaluation of neoplastic and infectious diseases in immunocompromised patients and their complications is difficult. Knowledge of the type of immunodeficiency remains the best tool for the formulation of an appropriate and timely diagnosis. Several strategies are helpful when interpreting imaging studies of patient with potential immune compromise. If the patient is HIV (+), correlation with the CD4 lymphocyte count is imperative as different diseases occur at the various CD4 count levels. When a patient’s HIV status is unknown and imaging findings suggest an HIV-related disease, the clinician should be encouraged to actively search for pertinent risk factors, and HIV testing should be offered. Likewise, correlation with the medical chart is also critical in the assessment of all other immunocompromised patients: congenital immunosupression, diabetes, transplantation, preexisting lung disease (e.g. asthma and COPD). The following chapters emphasize imaging findings as correlated with clinical and laboratory abnormalities in a variety of common immunodeficiencies.
{"title":"Introduction to the Immunocompromised Patient","authors":"S. Martinez-Jiménez","doi":"10.1093/MED/9780199858064.003.0041","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0041","url":null,"abstract":"Evaluation of neoplastic and infectious diseases in immunocompromised patients and their complications is difficult. Knowledge of the type of immunodeficiency remains the best tool for the formulation of an appropriate and timely diagnosis. Several strategies are helpful when interpreting imaging studies of patient with potential immune compromise. If the patient is HIV (+), correlation with the CD4 lymphocyte count is imperative as different diseases occur at the various CD4 count levels. When a patient’s HIV status is unknown and imaging findings suggest an HIV-related disease, the clinician should be encouraged to actively search for pertinent risk factors, and HIV testing should be offered. Likewise, correlation with the medical chart is also critical in the assessment of all other immunocompromised patients: congenital immunosupression, diabetes, transplantation, preexisting lung disease (e.g. asthma and COPD). The following chapters emphasize imaging findings as correlated with clinical and laboratory abnormalities in a variety of common immunodeficiencies.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123768160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0063
S. Martinez-Jiménez
Eosinophilic lung disease (ELD) comprises a group of disorders that affect the lungs and manifest with blood and/or tissue eosinophilia. ELD may be secondary to a variety of conditions such as infection by parasites (e.g. ascariasis, strongyloidiasis, paragonimiasis, etc.), drug reaction, bronchopulmonary aspergillosis (ABPA) and malignancy. ELD may also be a primary process either limited to the lung (e.g. acute and chronic eosinophilic disease) or as part of a systemic disorder (e.g. allergic granulomatosis with polyangiitis or hypereosinophilic syndrome). On imaging ABPA is characterized by tubular branching opacities that may exhibit the finger-in-glove sign (i.e. inspissated mucus within dilated central bronchi). Strongyloidiasis often manifests with multifocal pulmonary opacities affecting all pulmonary lobes. AEP may simulate cardiogenic pulmonary edema on imaging. Chronic eosinophilic pneumonia (CEP) may have varied imaging manifestations, including the so-called “photographic negative of pulmonary edema”.
{"title":"Eosinophilic Lung Diseases","authors":"S. Martinez-Jiménez","doi":"10.1093/MED/9780199858064.003.0063","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0063","url":null,"abstract":"Eosinophilic lung disease (ELD) comprises a group of disorders that affect the lungs and manifest with blood and/or tissue eosinophilia. ELD may be secondary to a variety of conditions such as infection by parasites (e.g. ascariasis, strongyloidiasis, paragonimiasis, etc.), drug reaction, bronchopulmonary aspergillosis (ABPA) and malignancy. ELD may also be a primary process either limited to the lung (e.g. acute and chronic eosinophilic disease) or as part of a systemic disorder (e.g. allergic granulomatosis with polyangiitis or hypereosinophilic syndrome). On imaging ABPA is characterized by tubular branching opacities that may exhibit the finger-in-glove sign (i.e. inspissated mucus within dilated central bronchi). Strongyloidiasis often manifests with multifocal pulmonary opacities affecting all pulmonary lobes. AEP may simulate cardiogenic pulmonary edema on imaging. Chronic eosinophilic pneumonia (CEP) may have varied imaging manifestations, including the so-called “photographic negative of pulmonary edema”.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126194589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0062
S. Martinez-Jiménez
Autoimmune diseases described herein include systemic lupus erythematosus (SLE), dermatomyositis/polymyositis (DM/PM), Sjögren syndrome (SS), and mixed connective tissue disease (MCTD). SLE predominantly affects women of reproductive age. Although pleural involvement is the most common thoracic manifestation, other manifestations include pneumonia, diffuse alveolar hemorrhage and lupus pneumonitis. Interstitial lung disease in patients with SLE include non-specific interstitial pneumonia (NSIP) and usual interstitial pneumonia (UIP). DM/PM affects the skeletal muscle and may frequently result in hypoventilation and respiratory failure (respiratory muscle involvement) and aspiration (laryngeal involvement). Interstitial lung disease is also frequent, and NSIP and organizing pneumonia are the most common patterns. SS typically affects women in the 4th to 5th decades of life. Classic symptoms include xerophtalmia and xerostomia. Interstitial lung disease is among the most common thoracic manifestations; and although NSIP, UIP, organizing pneumonia and amyloidoisis can occur, lymphocytic interstitial pneumonia (LIP) is a characteristic form of interstitial lung disease in SS. MCTD combines clinical features of RS, SLE, PSS and PM/DM. Thoracic involvement typically manifests with pulmonary hypertension and interstitial lung disease (NSIP, UIP and LIP). Pulmonary hypertension can occur in any autoimmune disease and is often associated with a worse prognosis. Chest radiography and thin-section chest CT (or HRCT) are the imaging modalities of choice to detect and assess thoracic manifestations of autoimmune disease.
{"title":"Other Autoimmune Diseases","authors":"S. Martinez-Jiménez","doi":"10.1093/MED/9780199858064.003.0062","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0062","url":null,"abstract":"Autoimmune diseases described herein include systemic lupus erythematosus (SLE), dermatomyositis/polymyositis (DM/PM), Sjögren syndrome (SS), and mixed connective tissue disease (MCTD). SLE predominantly affects women of reproductive age. Although pleural involvement is the most common thoracic manifestation, other manifestations include pneumonia, diffuse alveolar hemorrhage and lupus pneumonitis. Interstitial lung disease in patients with SLE include non-specific interstitial pneumonia (NSIP) and usual interstitial pneumonia (UIP). DM/PM affects the skeletal muscle and may frequently result in hypoventilation and respiratory failure (respiratory muscle involvement) and aspiration (laryngeal involvement). Interstitial lung disease is also frequent, and NSIP and organizing pneumonia are the most common patterns. SS typically affects women in the 4th to 5th decades of life. Classic symptoms include xerophtalmia and xerostomia. Interstitial lung disease is among the most common thoracic manifestations; and although NSIP, UIP, organizing pneumonia and amyloidoisis can occur, lymphocytic interstitial pneumonia (LIP) is a characteristic form of interstitial lung disease in SS. MCTD combines clinical features of RS, SLE, PSS and PM/DM. Thoracic involvement typically manifests with pulmonary hypertension and interstitial lung disease (NSIP, UIP and LIP). Pulmonary hypertension can occur in any autoimmune disease and is often associated with a worse prognosis. Chest radiography and thin-section chest CT (or HRCT) are the imaging modalities of choice to detect and assess thoracic manifestations of autoimmune disease.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120842463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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