Pub Date : 2019-07-01DOI: 10.1093/med/9780199858064.003.0053
B. Little
Pulmonary hamartoma is a benign neoplasm of the lung. It accounts for the majority of benign lung tumors. A hamartoma is composed of a variety of mesenchymal elements that may include cartilage, calcification, fat, epithelial cells, and smooth muscle. While benign, they are considered true neoplasms, and may demonstrate slow growth. Hamartomas are most commonly discovered in the 6th decade of life. Men have a 2-to-3 fold increased incidence compared to women. Most hamartomas are discovered incidentally. However, patients may rarely present with symptoms such as cough, hemoptysis, or recurrent pneumonia due to lesion proximity to the airway. On CT, hamartoma classically manifests as a small pulmonary nodule with intrinsic chondroid calcification and fat. These findings are essentially diagnostic of hamartoma. However, only 60% of hamartomas contain macroscopic fat, and even fewer (15%) exhibit characteristic “popcorn” calcification. Most hamartomas do not require resection, unless they are symptomatic. Other benign lesions also occur in the lung, but are much less common. A chondroma differs from a hamartoma in that is entirely comprised of cartilage. Chondromas are a component of Carney triad, which is also comprised of gastric leiomyosarcomas and extraadrenal paragangliomas. Lipomas and leiomyomas are other rare benign neoplasms, composed of fat and smooth muscle, respectively. Benign neurogenic neoplasms may also occur within the central airways.
{"title":"Airways Disease","authors":"B. Little","doi":"10.1093/med/9780199858064.003.0053","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0053","url":null,"abstract":"Pulmonary hamartoma is a benign neoplasm of the lung. It accounts for the majority of benign lung tumors. A hamartoma is composed of a variety of mesenchymal elements that may include cartilage, calcification, fat, epithelial cells, and smooth muscle. While benign, they are considered true neoplasms, and may demonstrate slow growth. Hamartomas are most commonly discovered in the 6th decade of life. Men have a 2-to-3 fold increased incidence compared to women. Most hamartomas are discovered incidentally. However, patients may rarely present with symptoms such as cough, hemoptysis, or recurrent pneumonia due to lesion proximity to the airway. On CT, hamartoma classically manifests as a small pulmonary nodule with intrinsic chondroid calcification and fat. These findings are essentially diagnostic of hamartoma. However, only 60% of hamartomas contain macroscopic fat, and even fewer (15%) exhibit characteristic “popcorn” calcification. Most hamartomas do not require resection, unless they are symptomatic. Other benign lesions also occur in the lung, but are much less common. A chondroma differs from a hamartoma in that is entirely comprised of cartilage. Chondromas are a component of Carney triad, which is also comprised of gastric leiomyosarcomas and extraadrenal paragangliomas. Lipomas and leiomyomas are other rare benign neoplasms, composed of fat and smooth muscle, respectively. Benign neurogenic neoplasms may also occur within the central airways.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"84 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":"124969395","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/9780199858064.003.0040
D. Palacio
Mycoplasma pneumoniae and viruses remain among the most common causes of community acquired pneumonia (CAP), and account for approximately 30% or more of all cases. M. pneumoniae is a bacterium that lacks a cell wall, which results in certain microbiologic features absent in other bacteria. The combination of centrilobular nodules, peribronchial thickening and lobular ground-glass attenuation on CT is the most suggestive pattern identified in patients with M. pneumoniae pneumonia. Although cellular bronchiolitis is a non-specific finding, a patchy or clustered distribution should raise the possibility of infectious etiology, with the most likely causative agents being M. pneumoniae, tuberculosis and viral bronchiolitis. The radiologic findings of adult viral and M. pneumoniae pneumonias are variable and depend on the host and the virulence of the pathogen. The imaging findings in this chapter overlap with those found in in pneumonias caused by atypical microorganisms (e.g. virus, PCP pneumonia, etc.). CT imaging of immunocompetent patients with suspected viral or mycoplasma pneumonia is not indicated unless there is suspicion of complications. CT may be performed in patients with normal, equivocal, or nonspecific radiographic findings. Conversely, CT is often indicated in immunocompromised patients with a normal chest radiograph and suspected pulmonary infection.
{"title":"Mycoplasma and Viral Pneumonia","authors":"D. Palacio","doi":"10.1093/MED/9780199858064.003.0040","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0040","url":null,"abstract":"\u0000 Mycoplasma pneumoniae and viruses remain among the most common causes of community acquired pneumonia (CAP), and account for approximately 30% or more of all cases. M. pneumoniae is a bacterium that lacks a cell wall, which results in certain microbiologic features absent in other bacteria. The combination of centrilobular nodules, peribronchial thickening and lobular ground-glass attenuation on CT is the most suggestive pattern identified in patients with M. pneumoniae pneumonia. Although cellular bronchiolitis is a non-specific finding, a patchy or clustered distribution should raise the possibility of infectious etiology, with the most likely causative agents being M. pneumoniae, tuberculosis and viral bronchiolitis. The radiologic findings of adult viral and M. pneumoniae pneumonias are variable and depend on the host and the virulence of the pathogen. The imaging findings in this chapter overlap with those found in in pneumonias caused by atypical microorganisms (e.g. virus, PCP pneumonia, etc.). CT imaging of immunocompetent patients with suspected viral or mycoplasma pneumonia is not indicated unless there is suspicion of complications. CT may be performed in patients with normal, equivocal, or nonspecific radiographic findings. Conversely, CT is often indicated in immunocompromised patients with a normal chest radiograph and suspected pulmonary infection.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"22 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":"128560889","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/9780199858064.003.0067
J. Azok
Silicosis and coal-workers pneumoconiosis (CWP) are fibrotic lung diseases secondary to the inhalation of free silica and coal dust. Exposure is typically occupational and occurs over many years before symptoms develop. Cough and shortness of breath are the most common presenting symptoms. Imaging features of silicosis and CWP are similar and often indistinguishable. Both silicosis and CWP result in upper lobe predominant disease. Pulmonary nodules are the most common imaging feature which may coalesce into progressive massive fibrosis. Lymphadenopathy and emphysema are additional findings seen in patients with silicosis and CWP. Silicosis has a higher incidence of tuberculosis and both pneumoconioses have a higher incidence of lung cancer.
{"title":"Silicosis and Coal Worker’s Pneumoconiosis","authors":"J. Azok","doi":"10.1093/MED/9780199858064.003.0067","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0067","url":null,"abstract":"Silicosis and coal-workers pneumoconiosis (CWP) are fibrotic lung diseases secondary to the inhalation of free silica and coal dust. Exposure is typically occupational and occurs over many years before symptoms develop. Cough and shortness of breath are the most common presenting symptoms. Imaging features of silicosis and CWP are similar and often indistinguishable. Both silicosis and CWP result in upper lobe predominant disease. Pulmonary nodules are the most common imaging feature which may coalesce into progressive massive fibrosis. Lymphadenopathy and emphysema are additional findings seen in patients with silicosis and CWP. Silicosis has a higher incidence of tuberculosis and both pneumoconioses have a higher incidence of lung cancer.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"40 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":"128156576","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/9780199858064.003.0016
Christopher M. Walker
Atelectasis resulting in an opaque hemithorax often indicates serious underlying disease including lung cancer or other tumors, with or without associated pleural effusion. Total lung atelectasis is usually caused by lung cancer obstructing a main bronchus, but can also result from mucus plugging, contralateral intubation of a main stem bronchus, bronchial stricture, or foreign body aspiration. A large amount of fluid and blood may be drawn into the collapsed lung with little or no loss of volume, resulting in a “drowned lung”. Chest radiographic findings of mediastinal shift toward or away from the opaque hemithorax, and associated findings pertaining to superior displacement of the ipsilateral hemidiaphragm and upper abdominal structures help establish volume loss as the etiology of the opaque hemithorax. Absence of these findings indicates preservation of volume in the ipsilateral hemithorax which may indicate the presence of a mass, an obstructing central lesion with associated drowned lung or a large pleural effusion with associated ipsilateral atelectasis. Pneumonectomy will result in an opaque hemithorax secondary to fluid filling of the pneumonectomy space. Unilateral pneumonia is a rare cause of opaque hemithorax.
{"title":"Atelectasis: Opaque Hemithorax","authors":"Christopher M. Walker","doi":"10.1093/MED/9780199858064.003.0016","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0016","url":null,"abstract":"Atelectasis resulting in an opaque hemithorax often indicates serious underlying disease including lung cancer or other tumors, with or without associated pleural effusion. Total lung atelectasis is usually caused by lung cancer obstructing a main bronchus, but can also result from mucus plugging, contralateral intubation of a main stem bronchus, bronchial stricture, or foreign body aspiration. A large amount of fluid and blood may be drawn into the collapsed lung with little or no loss of volume, resulting in a “drowned lung”. Chest radiographic findings of mediastinal shift toward or away from the opaque hemithorax, and associated findings pertaining to superior displacement of the ipsilateral hemidiaphragm and upper abdominal structures help establish volume loss as the etiology of the opaque hemithorax. Absence of these findings indicates preservation of volume in the ipsilateral hemithorax which may indicate the presence of a mass, an obstructing central lesion with associated drowned lung or a large pleural effusion with associated ipsilateral atelectasis. Pneumonectomy will result in an opaque hemithorax secondary to fluid filling of the pneumonectomy space. Unilateral pneumonia is a rare cause of opaque hemithorax.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"48 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":"128772625","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/9780199858064.003.0096
C. Jokerst, K. Cummings, A. Bierhals
The chest wall constitutes a relatively conspicuous space made up primarily of bones, muscles and fat. The chest wall also contains specialized tissues such as nerves, lymph nodes, blood vessels, and breast tissue. Abnormalities that lead to either masses or absence of these tissues are usually obvious upon visual inspection but occasionally imaging is required for evaluation. Differential diagnoses are very much based on the age, the symptoms and the tissue of origin. CT and MR are often both used as a result of their complementary nature. Congenital variations of the chest wall such as Poland syndrome, and Pectus Excavitum/carinatum must be understood to avoid confusion with pathology. Certain tumors are typical of the chest wall (Desmoid tumors and elastofibroma dorsi) and the thoracic radiologist should be familiar with their CT and MR appearances.
{"title":"Chest Wall Abnormalities","authors":"C. Jokerst, K. Cummings, A. Bierhals","doi":"10.1093/med/9780199858064.003.0096","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0096","url":null,"abstract":"The chest wall constitutes a relatively conspicuous space made up primarily of bones, muscles and fat. The chest wall also contains specialized tissues such as nerves, lymph nodes, blood vessels, and breast tissue. Abnormalities that lead to either masses or absence of these tissues are usually obvious upon visual inspection but occasionally imaging is required for evaluation. Differential diagnoses are very much based on the age, the symptoms and the tissue of origin. CT and MR are often both used as a result of their complementary nature. Congenital variations of the chest wall such as Poland syndrome, and Pectus Excavitum/carinatum must be understood to avoid confusion with pathology. Certain tumors are typical of the chest wall (Desmoid tumors and elastofibroma dorsi) and the thoracic radiologist should be familiar with their CT and MR appearances.","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":"129274768","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/9780199858064.003.0008
T. Ternes
Vascular catheters are hollow tubes used to gain access to the circulatory system. They are typically placed via large caliber vessels. Smaller caliber peripherally inserted central catheters (PICC) may be inserted via an antecubital vein. Vascular catheters are often placed temporarily for patients requiring intravenous drugs, fluid resuscitation, dialysis, or hemodynamic monitoring. For longer-term access, subcutaneous ports may be placed surgically. The ideal tip position for most central catheters is at the superior cavoatrial junction. Pulmonary artery catheters (PACs) are occasionally used in critically ill and postoperative patients for various purposes, including hemodynamic monitoring, but their use has generally decreased. An intraaortic baloon pump (IABP) consists of a long inflatable balloon mounted on a catheter used in patients with critical heart failure, with the goal of improving coronary flow. Follow-up radiographs are obtained after vascular catheter placement to exclude malposition or resultant complications.
{"title":"Vascular Catheters","authors":"T. Ternes","doi":"10.1093/med/9780199858064.003.0008","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0008","url":null,"abstract":"Vascular catheters are hollow tubes used to gain access to the circulatory system. They are typically placed via large caliber vessels. Smaller caliber peripherally inserted central catheters (PICC) may be inserted via an antecubital vein. Vascular catheters are often placed temporarily for patients requiring intravenous drugs, fluid resuscitation, dialysis, or hemodynamic monitoring. For longer-term access, subcutaneous ports may be placed surgically. The ideal tip position for most central catheters is at the superior cavoatrial junction. Pulmonary artery catheters (PACs) are occasionally used in critically ill and postoperative patients for various purposes, including hemodynamic monitoring, but their use has generally decreased. An intraaortic baloon pump (IABP) consists of a long inflatable balloon mounted on a catheter used in patients with critical heart failure, with the goal of improving coronary flow. Follow-up radiographs are obtained after vascular catheter placement to exclude malposition or resultant complications.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"40 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":"125445077","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/9780199858064.003.0018
Christopher M Walker
Lower lobe atelectasis may be the initial imaging manifestation of lung cancer, and its detection on chest radiography and/or CT often allows the interpreting radiologist to be the first to suggest the diagnosis. Affected patients may be asymptomatic or present with vague complaints. Varying degrees of lower lobe atelectasis may occur due to other etiologies. Moderate and marked degrees of lobar atelectasis typically result in a triangular-shaped opacity with its apex oriented towards the hilum. Displaced interlobar fissures are a direct (primary) sign of atelectasis. A unique imaging feature of right lower lobe atelectasis is associated displacement of the minor fissure, in addition to the displaced major fissure that characteristically occurs in right or left lower lobe atelectasis.
{"title":"Lower Lobe Atelectasis","authors":"Christopher M Walker","doi":"10.1093/MED/9780199858064.003.0018","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0018","url":null,"abstract":"Lower lobe atelectasis may be the initial imaging manifestation of lung cancer, and its detection on chest radiography and/or CT often allows the interpreting radiologist to be the first to suggest the diagnosis. Affected patients may be asymptomatic or present with vague complaints. Varying degrees of lower lobe atelectasis may occur due to other etiologies. Moderate and marked degrees of lobar atelectasis typically result in a triangular-shaped opacity with its apex oriented towards the hilum. Displaced interlobar fissures are a direct (primary) sign of atelectasis. A unique imaging feature of right lower lobe atelectasis is associated displacement of the minor fissure, in addition to the displaced major fissure that characteristically occurs in right or left lower lobe atelectasis.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"16 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":"114754971","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/9780199858064.003.0056
T. Henry, B. Little
Emphysema is the abnormal, permanent enlargement of air spaces distal to the terminal bronchioles, accompanied by destruction of alveolar walls, but without obvious fibrosis. Chronic obstructive pulmonary disease (COPD) is a spectrum of obstructive lung diseases that includes emphysema and chronic bronchitis – diseases that frequently coexist, especially in smokers. Emphysema is an extremely common disease and in most cases the diagnosis is established with clinical data including pulmonary function tests (PFTs). CT may be helpful for clarifying the diagnosis in mild cases or if another disease process (such as interstitial lung disease) is suspected. The three different types of emphysema (centrilobular, paraseptal, and panlobular) affect different parts of the secondary pulmonary lobule and are easily distinguished on CT. Emphysema distorts the normal lung anatomy and can cause superimposed processes (e.g. pneumonia or pulmonary edema) to look atypical on chest radiography and CT. Similarly, lung cancer may have an unusual morphology when it arises within emphysematous lung. Cystic lung disease and honeycombing in pulmonary fibrosis should not be confused with emphysema. Cysts and honeycombing have defined walls on CT, whereas centrilobular emphysema manifests as areas of low attenuation without perceptible walls.
{"title":"Emphysema","authors":"T. Henry, B. Little","doi":"10.1093/med/9780199858064.003.0056","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0056","url":null,"abstract":"Emphysema is the abnormal, permanent enlargement of air spaces distal to the terminal bronchioles, accompanied by destruction of alveolar walls, but without obvious fibrosis. Chronic obstructive pulmonary disease (COPD) is a spectrum of obstructive lung diseases that includes emphysema and chronic bronchitis – diseases that frequently coexist, especially in smokers. Emphysema is an extremely common disease and in most cases the diagnosis is established with clinical data including pulmonary function tests (PFTs). CT may be helpful for clarifying the diagnosis in mild cases or if another disease process (such as interstitial lung disease) is suspected. The three different types of emphysema (centrilobular, paraseptal, and panlobular) affect different parts of the secondary pulmonary lobule and are easily distinguished on CT. Emphysema distorts the normal lung anatomy and can cause superimposed processes (e.g. pneumonia or pulmonary edema) to look atypical on chest radiography and CT. Similarly, lung cancer may have an unusual morphology when it arises within emphysematous lung. Cystic lung disease and honeycombing in pulmonary fibrosis should not be confused with emphysema. Cysts and honeycombing have defined walls on CT, whereas centrilobular emphysema manifests as areas of low attenuation without perceptible walls.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"211 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":"114596406","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/9780199858064.003.0028
Christopher M Walker
The chapter titled pneumothorax discusses the radiographic and computed tomography (CT) manifestations of this entity. Pneumothorax may be divided clinically into three types: primary spontaneous, secondary spontaneous, and traumatic. Primary spontaneous pneumothorax is most common in tall, young male smokers and occurs in the absence of visible lung pathology. It is usually secondary to rupture of a small apical bleb or bulla. Secondary spontaneous pneumothorax occurs in patients with underlying lung pathology such as cavitary or cystic metastases, cystic lung disease, interstitial lung disease, and certain infections such as Pneumocystis jiroveci or Staphylococcus aureus pneumonia. Pneumothorax manifests on upright radiography as an apicolateral thin pleural line with no peripheral visible lung markings. On supine radiography, pneumothorax is more difficult to detect but may manifest with increased basal lucency, sharp delineation of adjacent structures such as mediastinal fat and hemidiaphragm, and the deep sulcus sign. Although tension pneumothorax is a clinical diagnosis, there are several radiographic signs that suggest the diagnosis including contralateral mediastinal shift and ipsilateral hemidiaphragm depression or inversion.
{"title":"Pneumothorax","authors":"Christopher M Walker","doi":"10.1093/med/9780199858064.003.0028","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0028","url":null,"abstract":"The chapter titled pneumothorax discusses the radiographic and computed tomography (CT) manifestations of this entity. Pneumothorax may be divided clinically into three types: primary spontaneous, secondary spontaneous, and traumatic. Primary spontaneous pneumothorax is most common in tall, young male smokers and occurs in the absence of visible lung pathology. It is usually secondary to rupture of a small apical bleb or bulla. Secondary spontaneous pneumothorax occurs in patients with underlying lung pathology such as cavitary or cystic metastases, cystic lung disease, interstitial lung disease, and certain infections such as Pneumocystis jiroveci or Staphylococcus aureus pneumonia. Pneumothorax manifests on upright radiography as an apicolateral thin pleural line with no peripheral visible lung markings. On supine radiography, pneumothorax is more difficult to detect but may manifest with increased basal lucency, sharp delineation of adjacent structures such as mediastinal fat and hemidiaphragm, and the deep sulcus sign. Although tension pneumothorax is a clinical diagnosis, there are several radiographic signs that suggest the diagnosis including contralateral mediastinal shift and ipsilateral hemidiaphragm depression or inversion.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"767 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":"116137613","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/9780199858064.003.0065
S. Bhalla
The term pneumoconiosis refers to lung disease related to dust inhalation. The inhaled particles produce a pulmonary reaction that may result in fibrosis as with asbestosis or silicosis or may result in a macrophage reaction with little fibrosis. Three key features must be addressed in a potential case of pneumoconiosis: identification of imaging signs of exposure, location of imaging findings and distribution of imaging abnormalities. Patients with pneumoconiosis may present with very subtle abnormalities usually well characterized on thin section CT or HRCT. When areas of cavitation are seen, tuberculosis must be considered in association with silicosis and coal worker pneumoconiosis. In addition, any noncalcified or indeterminate pulmonary nodule must be carefully assessed as some pneumoconioses, most notably silicosis and asbestosis, result in a higher incidence of primary lung cancer.
{"title":"Pneumoconiosis","authors":"S. Bhalla","doi":"10.1093/med/9780199858064.003.0065","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0065","url":null,"abstract":"The term pneumoconiosis refers to lung disease related to dust inhalation. The inhaled particles produce a pulmonary reaction that may result in fibrosis as with asbestosis or silicosis or may result in a macrophage reaction with little fibrosis. Three key features must be addressed in a potential case of pneumoconiosis: identification of imaging signs of exposure, location of imaging findings and distribution of imaging abnormalities. Patients with pneumoconiosis may present with very subtle abnormalities usually well characterized on thin section CT or HRCT. When areas of cavitation are seen, tuberculosis must be considered in association with silicosis and coal worker pneumoconiosis. In addition, any noncalcified or indeterminate pulmonary nodule must be carefully assessed as some pneumoconioses, most notably silicosis and asbestosis, result in a higher incidence of primary lung cancer.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"14 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":"124092927","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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