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Section: Thoracic Radiology

 




Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

The Radiologic and Pathologic Diagnosis of Biphasic Pulmonary Blastoma by Fadi Nemeh et al.

Published: 2017 Sep
Issue: 11(9) :: Pages: 10-21


Free full text article: The Radiologic and Pathologic Diagnosis of Biphasic Pulmonary Blastoma

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Abstract: Pulmonary blastomas are rare malignancies, representing 0.25% to 0.5% of all primary lung neoplasms with often aggressive progression and poor prognosis. Clinical management of pulmonary blastomas depends on histologic subtype, staging, and presentation, and may consist of surgery, chemotherapy, and radiation. Biphasic pulmonary blastoma is a subtype of pulmonary blastoma that exhibits biphasic histology, with both epithelial and mesenchymal malignant elements. We report a case of biphasic pulmonary blastoma in a 33-year-old female with 1 pack per day history of smoking for approximately 16 years, who presented with left-sided pleuritic chest pain on deep inspiration without otherwise significant pat medical history. Imaging evaluation using chest radiography, computed tomography, and magnetic resonance imaging identified a heterogenous, well-circumscribed, left lower lobe mass with extensive necrosis and hemorrhage. No lymphadenopathy or distant metastasis was detected through imaging evaluation. Surgical resection of the tumor followed by histopathological analysis confirmed a biphasic pulmonary blastoma.


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Conventional Radiography, Computed Tomography, Magnetic Resonance Imaging, Nuclear Medicine, Macroscopic pathology, Microscopic pathology, Table





Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Systemic Air Embolism after Percutaneous Lung Biopsy: A Manageable Complication by Lucas Fiore et al.

Published: 2017 Jun
Issue: 11(6) :: Pages: 6-14


Free full text article: Systemic Air Embolism after Percutaneous Lung Biopsy: A Manageable Complication

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Abstract: CT-guided percutaneous biopsy is a resourceful and widely used tool to evaluate pulmonary nodules that frequently avoids costly and unnecessary surgeries. Severe complications occur in less than 1% of cases and include gas embolism, which is rarely documented. We report a case of gas embolism after transthoracic biopsies and discuss the pathophysiology and the benefits of early diagnosis and proper management.


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Computed Tomography, Conventional Radiography, Table





Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Incidental finding - the discovery of a bronchopulmonary foregut malformation through investigations for Crohn`s disease by Humza Mahmood et al.

Published: 2017 Apr
Issue: 11(4) :: Pages: 10-19


Free full text article: Incidental finding - the discovery of a bronchopulmonary foregut malformation through investigations for Crohn`s disease

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Abstract: Pulmonary sequestration (PMS) is a rare bronchopulmonary malformation. It has an incidence of between 0.15% to 1.7%. Likewise, cystic adenomatoid malformation (CCAM) is another relatively rare category of a bronchopulmonary malformation with a reported incidence of between 1 in 25,000 to 1 in 35,000. Moreover, a bronchopulmonary malformation with features allied to both of these forms is considered an even rarer entity. In general, bronchopulmonary malformations present with a range of non-specific symptoms. Radiological features can be non-specific yet distinctive when related to clinical features. Ultimately, definitive diagnosis depends upon histological assessment of lung tissue. We present an adult female with radiological features of both pulmonary sequestration and cystic adenomatoid malformation. This was an incidental finding unrelated to the patients presenting complaint. This case highlights the importance of using a structured and systematic approach when interpreting medical imagery.


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Magnetic Resonance Imaging, Computed Tomography, Table





Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Mucoepidermoid carcinoma of the airways in a young adult male by Maarten Horst et al.

Published: 2017 Feb
Issue: 11(2) :: Pages: 8-15


Free full text article: Mucoepidermoid carcinoma of the airways  in a young adult male

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Abstract: Mucoepidermoid carcinoma (MEC) of the airways is a rare entity most often found in young patients. We present a case of a 23 year old patient with symptoms of pneumonia, which progresses to a pulmonary abscess within a week. Diagnostic work-up reveals an endobronchial obstruction by a pedunculated low grade MEC. A literature review is provided and radiological appearances are described.


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Conventional Radiography, Computed Tomography, Clinical image, Nuclear Medicine, Macroscopic pathology, Microscopic pathology, Table





Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Middle Lobe Torsion after Unilateral Lung Transplant by Chad S Cox et al.

Published: 2016 May
Issue: 10(5) :: Pages: 15-21


Free full text article: Middle Lobe Torsion after Unilateral Lung Transplant

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Abstract: Lobar torsion is well documented after pneumonectomy, but is very rare after lung transplant. To the best of our knowledge, this is the twelfth reported case of lobar torsion after lung transplant. In our case, bronchoscopies and chest radiographs were inconclusive; however, CT scan clearly demonstrated findings consistent with right middle lobe torsion. We review the literature and discuss the epidemiology, clinical presentation, imaging features, and treatment considerations for this condition. We also propose that if a clinical picture could be secondary to torsion and bronchoscopies and chest x ray are inconclusive that a CT scan should be obtained as soon as possible since early recognition increases the likelihood of being able to successfully detorse the lung and avoid lobectomy.


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Conventional Radiography, Computed Tomography, Macroscopic pathology, Table





Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Pulmonary Alveolar Microlithiasis - Clinico-Radiological dissociation - A case report with Radiological review by Sanjay Mhalasakant Khaladkar et al.

Published: 2016 Jan
Issue: 10(1) :: Pages: 14-21


Free full text article: Pulmonary Alveolar Microlithiasis -  Clinico-Radiological dissociation -  A case report with Radiological review

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Abstract: Pulmonary alveolar microlithiasis (PAM) is a rare chronic lung disease characterized by deposition of intra alveolar calcium and phosphate in bilateral lung parenchyma with predominance in lower and mid zones. Etiology and pathogenesis is not fully understood. However, mutation in SLC34A2 gene that encodes a sodium phosphate co-transporter in alveolar type-II cells resulting in formation and accumulation of microliths rich in calcium phosphate due to impaired clearance is considered the cause of disease. Patients with PAM are asymptomatic till development of hypoxemia and cor pulmonale. It remains static, while in some it progresses to pulmonary fibrosis, respiratory failure and cor pulmonale. We report a case of 44 year old male patient presenting with progressive shortness of breath on exertion for one year in duration with dry cough, more since last six months. Chest radiograph showed dense micronodular opacities giving classical sandstorm appearance. High resolution computed tomography (HRCT) showed microcalcification, subpleural cystic changes and calcified pleura. Lung biopsy showed calcospherites within alveolar spaces.


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Conventional Radiography, Computed Tomography, Microscopic pathology, Table





Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Unusual Pulmonary Arterial Filling Defect caused by Systemic to Pulmonary Shunt in the Setting of Chronic Lung Disease Demonstrated by Dynamic 4D CTA by Kianoush Ansari-Gilani et al.

Published: 2015 Nov
Issue: 9(11) :: Pages: 17-23


Free full text article: Unusual Pulmonary Arterial Filling Defect caused by Systemic to Pulmonary Shunt in the Setting of Chronic Lung Disease Demonstrated by Dynamic 4D CTA

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Abstract: Even though pulmonary embolism is by far the most common cause of filling defect in the pulmonary arterial system, other less common etiologies should be considered especially in the setting of atypical clinical scenario or unusual imaging findings. Unusual pattern of filling defect in the pulmonary artery in the setting of chronic inflammatory/fibrotic parenchymal lung disease should raise the concern for systemic to pulmonary artery shunt. This diagnosis is typically made by conventional angiography. Dynamic 4D CT angiography however can be a safe, noninvasive and effective alternative tool for making such a diagnosis. It has the added value of multiplanar reconstruction capabilities and providing detailed anatomy which can be vital for interventional radiologists when planning their approach for possible intervention. We present 2 cases of such shunts, and illustrate the demonstration of these shunts by using dynamic 4D CT angiography.


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Conventional Radiography, Computed Tomography, Table





Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Magnetic Resonance Imaging of the Lung as an Alternative for a Pregnant Woman with Pulmonary Tuberculosis by Manuel Schloß et al.

Published: 2015 May
Issue: 9(5) :: Pages: 7-13


Free full text article: Magnetic Resonance Imaging of the Lung as an Alternative for a Pregnant Woman with Pulmonary Tuberculosis

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Abstract: We report a case of a pregnant 21-year-old woman with pulmonary tuberculosis in which magnetic resonance imaging of the lung was used to assess the extent and characteristics of the pathological changes. Although the lung has been mostly ignored in magnetic resonance imaging for many decades, today technical development enables detailed examinations of the lung. The technique is now entering the clinical arena and its indications are increasing. Magnetic resonance imaging of the lung is not only an alternative method without radiation exposure, it can provide additional information in pulmonary imaging compared to other modalities including computed tomography. We describe a successful application of magnetic resonance imaging of the lung and the imaging appearance of post-primary tuberculosis. This case report indicates that magnetic resonance imaging of the lung can potentially be the first choice imaging technique in pregnant women with suspected pulmonary tuberculosis.


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Conventional Radiography, Magnetic Resonance Imaging, Table





Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Pulmonary Imaging Abnormalities in an Adult Case of Congenital Lobar Emphysema by Damien Pike et al.

Published: 2015 Feb
Issue: 9(2) :: Pages: 9-15


Free full text article: Pulmonary Imaging Abnormalities in an Adult Case of Congenital Lobar Emphysema

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Abstract: Congenital lobar emphysema is mainly diagnosed in infants, although rare cases are reported in adults. A 20-yr-old female with acute dyspnea, chest pain and left upper lobe (LUL) chest x-ray hyperlucency underwent 3He magnetic resonance imaging (MRI) for ventilation and apparent diffusion coefficient (ADC) measurements, as well as CT for emphysema and airway wall measurements. Forced expiratory volume in 1s, residual volume, and airways-resistance were abnormal, but there was normal carbon-monoxide-diffusing-capacity. The LUL relative area of the density histogram <-950 HU and airway morphology were highly abnormal compared with the other lobes and coincident with highly abnormal MRI-derived acinar duct dimensions. CT also identified bronchial atresia and congenital lobar emphysema as the source of symptoms in this case where there was also functional imaging evidence of collateral ventilation from the fissure (and not the abnormally terminated airway) into the emphysematous LUL.


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Conventional Radiography, Computed Tomography, Magnetic Resonance Imaging, Table





Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Apical Pneumocystis jiroveci as an AIDS defining illness: A case report illustrating a change in the paradigm by Kyle Pfeifer et al.

Published: 2014 Nov
Issue: 8(11) :: Pages: 15-24


Free full text article: Apical Pneumocystis jiroveci as an AIDS defining illness: A case report illustrating a change in the paradigm

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Abstract: Pneumocystis jiroveci pneumonia is a common acquired immune deficiency syndrome defining illness. Pneumocystis jiroveci pneumonia is classically described as having symmetrical bilateral perihilar ground-glass opacities on chest radiographs. We present an "atypical" case of Pneumocystis jiroveci pneumonia presenting as symmetric biapical cystic spaces with relative sparing of the remainder of the lungs in a 22 year-old male, previously undiagnosed with acquired immune deficiency syndrome. Our case illustrates that formerly unusual presentations of Pneumocystis jiroveci pneumonia are becoming more common as acquired immune deficiency syndrome defining illnesses as more patients are being imaged with further imaging such as high resolution computed tomography.


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Conventional Radiography, Computed Tomography, Microscopic pathology, Table

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Bronchopulmonary sequestration in a 60 year old man by Lena Naffaa et al.

Published: 2014 Oct
Issue: 8(10) :: Pages: 32-39


Free full text article: Bronchopulmonary sequestration in a 60 year old man

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Abstract: We report a case of bronchopulmonary sequestration (BPS) in a 60 year old man with recurrent cough. After failed antibiotic therapy for presumed left lower lobe (LLL) pneumonia seen on chest radiographs, bronchoscopy was performed revealing cryptogenic organizing pneumonia. Further work-up with thoracic imaging demonstrates a feeding artery from the thoracic aorta to the LLL consolidation indicating the presence of BPS. A brief review of the clinical and radiological features and management options of BPS are listed, with particular emphasis on the various imaging modalities and techniques in the diagnosis and pre-surgical planning of intralobar sequestration.


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Conventional Radiography, Computed Tomography, Magnetic Resonance Imaging, Table

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Bilateral Mobile Thoracolithiasis by Rajesh Bhayana et al.

Published: 2014 Sep
Issue: 8(9) :: Pages: 16-20


Free full text article: Bilateral Mobile Thoracolithiasis

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Abstract: Thoracolithiasis is the presence of one or more freely mobile pleural stones (with or without calcification) in the pleural space. They occur with a reported incidence of less than 0.1% and are benign and do not require intervention. Historically, they have led to unnecessary interventions - something unlikely in the era of multidetector computed tomography (CT). Thoracolithiasis should be included in the differential diagnosis of a single or multiple, mobile peripheral pulmonary nodules. Here, we review the imaging characteristics of a rare case of bilateral mobile thoracolithiasis.


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Computed Tomography, Conventional Radiography, Table

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Intercostal lung herniation - The role of imaging by Efstathios E. Detorakis et al.

Published: 2014 Apr
Issue: 8(4) :: Pages: 16-24


Free full text article: Intercostal lung herniation - The role of imaging

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Abstract: Extrathoracic lung hernias can be congenital or acquired. Acquired hernias may be classified by etiology into traumatic, spontaneous, and pathologic. We present a case of a 40-year-old male with a history of bronchial asthma and a blunt chest trauma who presented complaining of sharp chest pain of acute onset that began after five consecutive days of vigorous coughing. Upon physical examination a well-demarcated deformity overlying the third intercostal space of the left upper anterior hemithorax was revealed. Thoracic CT scan showed that a portion of the anterior bronchopulmonary segment of the left upper lobe had herniated through a chest wall defect. The role of imaging, especially chest computed tomography with multiplanar image reconstructions and maximum (MIP) and minimum intensity projection (MinIP) reformats can clearly confirm the presence of the herniated lung, the hernial sac, the hernial orifice in the chest wall, and exclude possible complications such as lung tissue strangulation.


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Conventional Radiography, Computed Tomography, Table

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

A case of systemic arterial supply to the right lower lobe of the lung: imaging findings and review of the literature by Marcela Mautone et al.

Published: 2014 Mar
Issue: 8(3) :: Pages: 9-15


Free full text article: A case of systemic arterial supply to the right lower lobe of the lung: imaging findings and  review of the literature

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Abstract: Systemic arterialization of the lung without pulmonary sequestration is the rarest form of anomalous systemic arterial supply to the lung. This condition is characterised by an aberrant arterial branch arising from the aorta which supplies an area of lung parenchyma with normal bronchopulmonary anatomy. It is often diagnosed following investigation of an incidental cardiac murmur or based on abnormal imaging, as most patients are asymptomatic or minimally symptomatic. Thoracic computed tomography and computed tomography angiography are generally the most useful diagnostic tests. We present a case of a 22-year old female who was diagnosed with systemic arterial supply to a portion of otherwise normal right lower lobe following investigation of low volume haemoptysis.


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Conventional Radiography, Computed Tomography, Table

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Catheter-directed clot fragmentation using the CleanerTM device in a patient presenting with massive pulmonary embolism by Barjaktarevic I et al.

Published: 2014 Feb
Issue: 8(2) :: Pages: 30-36


Free full text article: Catheter-directed clot fragmentation using the Cleaner<sup>TM</sup> device in a patient presenting with massive pulmonary embolism

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Abstract: Massive pulmonary embolism not amenable to systemic thrombolysis is a therapeutic challenge. Catheter directed clot fragmentation and thrombolysis have been efficacious in this setting. We describe successfully treating a massive pulmonary embolism with catheter-directed thrombolysis and clot fragmentation using local tPA, aspiration, and the CleanerTM device in a patient with an absolute contraindication to systemic thrombolysis.


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Computed Tomography, Angiography, Interventional, Table

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Unique Venocaval Anomalies: Case of Duplicate Superior Vena Cava and Interrupted Inferior Vena Cava by Iris Hagans et al.

Published: 2014 Jan
Issue: 8(1) :: Pages: 20-26


Free full text article: Unique Venocaval Anomalies:  Case of Duplicate Superior Vena Cava and  Interrupted Inferior Vena Cava

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Abstract: Venocaval anomalies are uncommon in the general population and often go unrecognized, but physicians should be aware of their significance. Duplicate superior vena cava should be identified during cardiac imaging, surgery, and catheter insertions. While interrupted inferior vena cava can predispose to thrombus formation, they protect against pulmonary embolism from lower extremity deep vein thrombosis. We describe a unique case of a patient in which combined superior vena cava and inferior vena cava anomalies were found incidentally. This is the first reported case of a duplicate superior vena cava and interrupted inferior vena cava in a single patient in English literature. This article also provides a literature review on the topic.


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Conventional Radiography, Computed Tomography, Ultrasound, Angiography, Interventional, Graph, Table

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

A Case of Acute Traumatic Aortic Injury of a Right-sided Aortic Arch with Rupture of an Aberrant Left Subclavian Artery by Sawsan Taif et al.

Published: 2013 Dec
Issue: 7(12) :: Pages: 1-9


Free full text article: A Case of Acute Traumatic Aortic Injury of a  Right-sided Aortic Arch with Rupture of an  Aberrant Left Subclavian Artery

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Abstract: Acute traumatic aortic injury is a potentially lethal condition with most patients die at the scene of the accidents. Rapid deceleration due to motor vehicle accidents is the commonest mechanism of injury. These injuries can be successfully repaired in the few patients who survive the initial trauma if proper diagnosis and rapid treatment are provided. The occurrence of acute traumatic aortic injury in patients with congenital abnormality of the aortic arch has been rarely reported; however, it renders the diagnosis and treatment more difficult. In this paper, we describe an extremely rare case of aortic injury in a young patient who had a right sided aortic arch with rupture of an aberrant left subclavian artery. The patient was suspected to have a Kommerell`s diverticulum in the aberrant subclavian artery origin. This injury resulted in an unusually huge pseudoaneurysm involving part of the mediastinum and extending into the neck. Unfortunately; patient succumbed in spite of surgical intervention.


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Conventional Radiography, Computed Tomography, Table

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Case report: Positron emission tomography fails to detect pulmonary adenocarcinoma recurrence after radiofrequency ablation by Cara Odenthal et al.

Published: 2013 Nov
Issue: 7(11) :: Pages: 15-23


Free full text article: Case report: Positron emission tomography fails to detect pulmonary adenocarcinoma recurrence after radiofrequency ablation

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Abstract: We describe the case of late recurrence of a focus of invasive mucinous adenocarcinoma (formerly mucinous bronchioloalveolar carcinoma) following radiofrequency ablation, despite a negative positron emission tomography/computed tomography scan at 13 months following the ablation. A computed tomography scan performed at 24 months demonstrated unequivocal recurrence of the lesion. Combined positron emission tomography/computed tomography has been described as an adequate modality for the follow-up of thermally ablated pulmonary lesions. However, its utility in the follow-up of well-differentiated pulmonary adenocarcinoma may be limited. Lesion activity may be underestimated by an inherently low metabolic activity. Small lesions may also be susceptible to partial volume effect. Long-term imaging follow-up of well-differentiated pulmonary adenocarcinoma beyond two years after thermal ablation is prudent to avoid missing late recurrence.


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Computed Tomography, Nuclear Medicine, Table





Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Reversed Halo Sign on CT as a Presentation of Lymphocytic Interstitial Pneumonia by Marcus D Freeman et al.

Published: 2013 Oct
Issue: 7(10) :: Pages: 51-56


Free full text article: Reversed Halo Sign on CT as a Presentation of Lymphocytic Interstitial Pneumonia

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Abstract: A 52 year-old African American female with a past medical history of symptomatic uterine fibroids and increasing abdominal circumference underwent abdominal computed tomography (CT) as part of her workup. Because of an abnormality in the left lower lobe, CT of the chest was subsequently performed and showed a focal region of discontinuous crescentic consolidation with central ground glass opacification in the right lower lobe, suggestive of the reversed halo sign. The patient underwent percutaneous CT-guided core biopsy of the lesion, which demonstrated lymphocytic interstitial pneumonia, a benign lymphoproliferative disease characterized histologically by small lymphocytes and plasma cells. This case report describes the first histologically confirmed presentation of lymphocytic interstitial pneumonia with the reversed halo sign on CT.


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Computed Tomography, Microscopic pathology, Table

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Rare Case of Left Upper Lobe Partial Anomalous Pulmonary Venous Connection by Rahul Nath et al.

Published: 2013 Jun
Issue: 7(6) :: Pages: 9-14


Free full text article: Rare Case of Left Upper Lobe Partial Anomalous Pulmonary Venous Connection

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Abstract: Partial anomalous pulmonary venous connection is a rare abnormality with failure of connection between the initial draining system of the lungs and the common pulmonary vein. Right sided anomalous return is the most common form of anomalous connection, with left sided anomalous return uncommon. Presented is a case of left upper lobe partial anomalous pulmonary venous connection that was diagnosed incidentally on computed tomography (CT). This is an example of the utility of CT, in particular coronal, sagittal and 3-d reconstructions, in assessment of cardiopulmonary anatomy.


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Conventional Radiography, Computed Tomography, Graph, Table

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

The Empty Azygos Fissure by Vincent Lenoir et al.

Published: 2013 Apr
Issue: 7(4) :: Pages: 10-15


Free full text article: The Empty Azygos Fissure

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Abstract: The azygos fissure is typically visible on chest radiography as a right para-mediastinal supernumerary line in projection of the right lung apex. The azygos vein, located at the bottom of the fissure, is visible as a teardrop-shaped opacity. The empty azygos fissure is a rare finding. It is the consequence of the displacement of the azygos vein out of the fissure with a close paramediastinal position. This phenomenon, related to lung collapse, has been described in the literature as the migration of the azygos vein due to various etiologies such as increased intrathoracic pressure, spontaneous or iatrogenic pneumothorax, or even during sudden development of kyphosis. In our clinical case, the empty azygos fissure was developed after drainage of a large right pleural effusion. An empty azygos fissure must therefore suggest a history of pulmonary atelectasis related to pneumothorax or large drained effusion.


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Computed Tomography, Conventional Radiography, Graph, Table

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Tracheobronchopathia Osteochondroplastica - A rare or an overlooked entity? by Shikha Jindal et al.

Published: 2013 Mar
Issue: 7(3) :: Pages: 16-25


Free full text article: Tracheobronchopathia Osteochondroplastica - A rare or an overlooked entity?

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Abstract: Tracheobronchopathia osteochondroplastica is an idiopathic non-malignant disease of large airways featured by submucosal cartilaginous to osseous nodules overlying the cartilaginous rings, which may be focal or diffuse. Clinical presentation varies from asymptomatic to symptoms like breathlessness, recurrent chest infections, cough and hemoptysis. Due to the lack of awareness of this disease, it remains an under recognized entity. We are describing the computed tomography and bronchoscopic findings of two recently diagnosed cases at our institute. The purpose of this report is to familiarize radiologists with imaging appearance of this condition, with the goal of increasing clinical suspicion of this uncommon condition.


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Conventional Radiography, Computed Tomography, Clinical image, Microscopic pathology, Table

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Characterization of Malignant Thrombus in an Invasive Thymoma with Intravascular Growth by Sevtap Gümüstas et al.

Published: 2013 Feb
Issue: 7(2) :: Pages: 17-23


Free full text article: Characterization of Malignant Thrombus in an Invasive Thymoma with Intravascular Growth

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Abstract: We report an unusual case of an invasive thymoma with a thrombus in the right atrium and describe the radiological findings consistent with the malignant nature of the thrombus. The thrombus showed significant enhancement on computerized tomography images similar to the tumoral mass. On magnetic resonance imaging, both the tumor and the thrombus have heterogeneously high signal intensities on T2-weighted images. On diffusion-weighted images they both exhibit high signal intensity and low apparent diffusion coefficient (ADC) values which support the malignant nature of the thrombus and the mass.


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Computed Tomography, Magnetic Resonance Imaging, Table

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

A Case of Colorectal Cancer with Metastasis to the Chest Wall and Subsequent Hematoma Formation by Joseph N Stember et al.

Published: 2013 Jan
Issue: 7(1) :: Pages: 18-24


Free full text article: A Case of Colorectal Cancer with Metastasis to the Chest Wall and Subsequent Hematoma Formation

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Abstract: We report a rare case of a patient with colorectal cancer with chest wall metastases. The development of bleeding at the site of the metastasis ultimately resulted in the development of a hematoma, necessitating resection of the tumor along with part of the chest wall. Literature on chest wall metastases of colonic adenocarcinoma is reviewed and discussed. The teaching point is that a chest wall mass seen on imaging should prompt consideration of metastatic cancer in the differential diagnosis. The colon is a rare though reported primary site.


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Conventional Radiography, Computed Tomography, Nuclear Medicine, Microscopic pathology, Table

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A Complex Pulmonary Vein Varix - Diagnosis with ECG gated MDCT, MRI and Invasive Pulmonary Angiography by Zuzana Berecova et al.

Published: 2012 Dec
Issue: 6(12) :: Pages: 9-16


Free full text article: A Complex Pulmonary Vein Varix -  Diagnosis with ECG gated MDCT, MRI and Invasive Pulmonary Angiography

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Abstract: A case of an asymptomatic 32-year-old male with a complex congenital pulmonary vein varix is reported herein. Chest X-ray incidentally revealed a tubular opacity passing from the periphery of the left lingula to the mediastinum. ECG gated multidetector computed tomography showed the opacity to be a vessel emptying into the left atrium via the left superior pulmonary vein. In addition, a second vascular structure was noted within the posterior mediastinum that was emptying into the same pulmonary vein. These findings were also confirmed by magnetic resonance imaging, 4D magnetic resonance angiography and invasive arterial angiography. Based on multimodality imaging findings the diagnosis of complex congenital pulmonary venous varix with posterior mediastinal extension was established.


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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Multisystemic Langerhans Cell Histiocytosis with advanced lung involvement by Ricardo Andrade Fernandes de Mello¹*, Joana Waked Tanos¹, Melissa Bozzi Nonato Mello¹, Edson Marchiori2 et al.

Published: 2012 Nov
Issue: 6(11) :: Pages: 22-28


Free full text article: Multisystemic Langerhans Cell Histiocytosis with advanced lung involvement

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Abstract: Langerhans cell histiocytosis is a rare disease of unknown cause, characterized by the proliferation of histiocytic cells (Langerhans cells), that can sometimes be especially difficult to diagnose due to its wide clinical spectrum, ranging from a single lesion to a multisystemic disorder. Appropriate disease staging is fundamental, since treatment depends upon the severity of the disease, and imaging methods play a fundamental role not only in diagnosing and assessing the extent of Langerhans cell histiocytosis, as well as guiding the appropriate treatment for the patient and their monitoring.


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Clinical image, Microscopic pathology, Conventional Radiography, Computed Tomography, Table

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Bronchial carcinosarcoma by Carolina Carcano et al.

Published: 2012 Oct
Issue: 6(10) :: Pages: 26-31


Free full text article: Bronchial carcinosarcoma

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Abstract: Carcinosarcoma is an uncommon mixed tumor of the lung. We present the case of a 65 year-old-male with cough and a right lower lobe radio-opacity who underwent resection, showing a large endobronchial tumor with an epithelial component of non-small cell carcinoma and malignant mesenchymal elements. The radiologic and histopathologic features are reviewed with reference to relevant literature.


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Percutaneous embolization of an incidentally diagnosed pulmonary aneurysm in a scleroderma patient by Eyal Lotan et al.

Published: 2012 Jun
Issue: 6(6) :: Pages: 29-34


Free full text article: Percutaneous embolization of an incidentally diagnosed pulmonary aneurysm in a scleroderma patient

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Abstract: A 59-year-old female with history of progressive scleroderma and pulmonary fibrosis was referred for biopsy of a pulmonary nodule that was discovered on computed-tomography (CT) chest surveillance, not present on prior CT-scan. Imaging was suspicious for granuloma, malignancy or aneurysm. CT-Angiography (CTA), performed immediately before the procedure, did not show enhancement of the mass, followed by placement of coaxial-needle into the mass. Suspicion of aneurysm was again raised and repeat CTA demonstrated contrast filling of the aneurysm. With the coaxial-needle in the aneurysm, embolization of the sac was performed using microfibrillar collagen, followed by confirmation of containment and thrombosis with CT.


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Computed Tomography, Table

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Bilateral shotgun pellet pulmonary emboli by Stephen Huebner et al.

Published: 2012 Apr
Issue: 6(4) :: Pages: 1-10


Free full text article: Bilateral shotgun pellet pulmonary emboli

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Abstract: Intravascular migration of bullets and other foreign bodies is a rare but known complication of penetrating trauma. Missile embolization can represent a diagnostic challenge because it may present in various and unexpected ways. We present the case of a 54-year-old female who sustained shotgun pellet emboli to the pulmonary arteries following a left upper extremity gunshot wound and related vascular surgery. The case illustrates bilateral embolization, and the embolic events occurred following surgery. Embolization should be considered in evaluating patients with gunshot wounds, particularly if there are anomalous symptoms or the projectile is not found in the original, or expected, location. Close attention to the location of the foreign bodies on serial radiographs may reveal the diagnosis of intravascular embolization.


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Conventional Radiography, Angiography, Interventional, Computed Tomography, Table

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Pulmonary Embolism Following 2-Octyl-Cyanoacrylate/Lipiodol Injection for Obliteration of Gastric Varices: An Imaging Perspective by Adam Daniel Singer et al.

Published: 2012 Feb
Issue: 6(2) :: Pages: 17-22


Free full text article: Pulmonary Embolism Following 2-Octyl-Cyanoacrylate/Lipiodol Injection for Obliteration of Gastric Varices: An Imaging Perspective

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Abstract: Bleeding from esophageal and gastric varices remains a significant cause of morbidity and mortality for patients with liver cirrhosis. Currently, therapeutic strategies for gastric variceal bleeding include transjugular intrahepatic portosystemic shunt, cyanoacrylate sclerotherapy and hepatic transplantation. Though relatively safe and efficacious, endoscopic sclerotherapy using cyanoacrylate has known complications including infection, bleeding, and distal embolization. This case report describes a patient who became febrile and tachycardic following sclerotherapy and subsequently had an abnormal chest radiograph that prompted further evaluation for pulmonary embolization of the sclerosant. The focuses of this report are the computed tomographic and radiographic findings associated with 2-octyl-cyanoacrylate/lipiodol pulmonary embolization.


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Conventional Radiography, Computed Tomography, Table

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Thoracic endometriosis: a case report by Priyank S Chatra

Published: 2012 Jan
Issue: 6(1) :: Pages: 25-30


Free full text article: Thoracic endometriosis: a case report

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Abstract: Thoracic endometriosis is a rare form of extrapelvic endometriosis. These patients typically present with catamenial pneumothorax or hemoptysis. Adequate clinical history coupled with HRCT helps in early diagnosis and appropriate management of thoracic endometriosis.


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Ultrasound, Computed Tomography, Table

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A case of type A aortic dissection with underlying fibromuscular dysplasia by Viesha Ciura et al.

Published: 2011 Oct
Issue: 5(10) :: Pages: 22-28


Free full text article: A case of type A aortic dissection with underlying fibromuscular dysplasia

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Abstract: Fibromuscular dysplasia is a rare, non-atherosclerotic non-inflammatory vascular disease that most commonly involves the renal arteries and carotid arteries, but has been described in nearly every vascular bed in the body. Complications of fibromuscular dysplasia include aneurysms and vascular dissection. We present a rare case of fibromuscular dysplasia involving the aorta, complicated by type A aortic dissection.


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Incidentally detected unilateral pulmonary artery agenesis with pulmonary hypoplasia in a 67 year old woman by Prakash Muthusami et al.

Published: 2010 Nov
Issue: 4(11) :: Pages: 32-37


Free full text article: Incidentally detected unilateral pulmonary artery agenesis with pulmonary hypoplasia in a 67 year old woman

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Abstract: Unilateral pulmonary artery agenesis is commonly seen associated with other congenital cardiovascular defects, when it is detected early in life, but isolated absence of the pulmonary artery is a rare entity, usually detected in adulthood. The latter patients are usually asymptomatic or might present with varied non-specific manifestations such as respiratory tract infections and hemoptysis. This report describes the imaging findings of a 67 year old female with absence of the right pulmonary artery. The embryology and clinical manifestations of the condition are reviewed.


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Conventional Radiography, Computed Tomography, Magnetic Resonance Imaging, Table

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Spontaneous Pneumomediastinum Due to Achalasia: An Unusual but Benign Cause by Ramin Javan et al.

Published: 2010 Nov
Issue: 4(11) :: Pages: 38-43


Free full text article: Spontaneous Pneumomediastinum Due to Achalasia: An Unusual but Benign Cause

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Abstract: Pneumomediastinum is usually first identified radiographically in the emergency department. Distinguishing benign from more ominous causes, such as esophageal rupture, is imperative, particularly in the setting of associated esophageal disease. We describe a case, with correlative imaging, of spontaneous pneumomediastinum as the initial presentation of achalasia. A general discussion of spontaneous pneumomediastinum is also provided, including the pathophysiology, precipitating and predisposing factors, clinical manifestations, role of radiology in the diagnosis as well as the radiographic signs.


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Conventional Radiography, Computed Tomography, Fluoroscopy, Table

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Pulmonary Schistosomiasis – Imaging Features by Niemann T et al.

Published: 2010 Sep
Issue: 4(9) :: Pages: 37-43


Free full text article: Pulmonary Schistosomiasis – Imaging Features

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Abstract: Schistosomiasis is a helminthic infection that is endemic in tropical and subtropical regions. Pulmonary involvement can be divided into two categories: acute or chronic compromise. Chronic and recurrent infection develops in persons living or travelling in endemic areas. In the lungs, granuloma formation and fibrosis around the schistosome eggs retained in the pulmonary vasculature may result in obliterative arteriolitis and pulmonary hypertension leading to cor pulmonale. Acute schistosomiasis is associated with primary exposure and is commonly seen in nonimmune travelers. The common CT findings in acute pulmonary schistosomiasis are small pulmonary nodules ranging from 2 to 15 mm and larger nodules with ground glass-opacity halo. Katayama fever is a severe clinical manifestation of acute involvement. We present a case of pulmonary involvement in schistosomiasis and provide a discussion about typical imaging findings in the acute and chronic form.


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Microscopic pathology, Conventional Radiography, Computed Tomography, Table

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Endobronchial granular cell tumor: a case report by Monique Anne Meyer et al.

Published: 2010 Aug
Issue: 4(8) :: Pages: 29-35


Free full text article: Endobronchial granular cell tumor: a case report

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Abstract: Granular cell tumors (GCTs) are benign neoplasms that are most commonly found in the head and neck region. We present a case of endobronchial granular cell tumor presenting as hemoptysis in a 22-year-old African American female. Patient subsequently underwent a right upper and middle lobectomy, and upon histologic analysis was found to have GCT with borders impinging upon cartilage and adjacent peribronchial lymph nodes.


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Conventional Radiography, Computed Tomography, Microscopic pathology, Table

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Pseudocoarctation with saccular aneurysms, left sided SVC and aberrant right subclavian artery - A case report by Balaji Rao et al.

Published: 2010 Jul
Issue: 4(7) :: Pages: 29-33


Free full text article: Pseudocoarctation with saccular aneurysms, left sided SVC and aberrant right subclavian artery - A case report

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Abstract: Pseudocoarctaion is a rare congenital anomaly due to elongation of aortic arch. The exact etiology is still uncertain. It may be associated with other congenital cardiac and vascular anomalies. We report an unusual case of pseudocarctation associated with aberrant right subclavian artery, left SVC and multiple saccular aneurysms in the kinked arch and we feel that this is the first documented case in literature.


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Conventional Radiography, Computed Tomography, Table

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Spontaneous Pneumomediastinum Associated with Sex by Sam Flatman et al.

Published: 2010 Apr
Issue: 4(4) :: Pages: 25-29


Free full text article: Spontaneous Pneumomediastinum Associated with Sex

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Abstract: We present a case of spontaneous pneumomediastinum (SPM) associated with sex. A 22-year-old lesbian with a history of asthma, cigarette and illicit drug smoking was diagnosed with a SPM after developing chest pain and dyspnoea in the context of performing oral sex. The main finding was subcutaneous emphysema involving the neck. SPM is an important differential diagnosis for chest pain in young people. It is a benign condition and diagnosis mainly limited to chest X-ray with increased incidence in asthmatics, smokers and drug addicts.


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Conventional Radiography, Computed Tomography

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

CT Utilization in the Prospective Diagnosis of a Case of Swine-Origin Influenza A (H1N1) Viral Infection by Amr M. Ajlan et al.

Published: 2010 Mar
Issue: 4(3) :: Pages: 24-30


Free full text article: CT Utilization in the Prospective Diagnosis of a Case of Swine-Origin Influenza A (H1N1) Viral Infection

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Abstract: The purpose of this paper is to demonstrate the potential role of CT in the early diagnosis of swine-origin influenza A (H1N1) virus (S-OIV) pneumonia. We present a case of acute influenza-like illness in which the CT findings of peribronchovascular and subpleural ground-glass opacities and consolidation resembled organizing pneumonia, and lead the radiologist to prospectively and correctly suggest the diagnosis of S-OIV infection.


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Conventional Radiography, Computed Tomography, Table

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Chronic pulmonary aspergillosis - longterm follow-up over 20 years, a case report by Henry Marshall et al.

Published: 2010 Feb
Issue: 4(2) :: Pages: 23-30


Free full text article: Chronic pulmonary aspergillosis - longterm follow-up over 20 years, a case report

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Abstract: We describe a case of chronic pulmonary aspergillosis complicated with a slowly growing aspergilloma followed for two decades without specific intervention. It developed with no background of local or systemic immune dysfunction in a middle aged female. The case illustrates many features of this disease as well as uniquely documenting the natural radiological evolution from a small non-specific cystic lesion to a massive aspergilloma. The aspergilloma subsequently autolysed and the patient`s condition changed to an allergic phenotype with development of widespread bronchiectasis and pulmonary fibrosis. We briefly discuss the range of disease aspergillus can cause in humans, its differential diagnosis and treatments.


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Conventional Radiography, Computed Tomography, Table

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Compensatory dilatation of the Azygos Venous system Secondary To Superior Vena Cava Occlusion by Francesco Paoletti et al.

Published: 2009 Dec
Issue: 3(12) :: Pages: 49-55


Free full text article: Compensatory dilatation of the Azygos Venous system Secondary To Superior Vena Cava Occlusion

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Abstract: Superior vena cava (SVC) occlusion can be clinically recognized in the acute setting when the stenosing process does not allow the development of collateral venous channels, which guarantee the venous drainage to the right heart. On the contrary, when the obstruction develops progressively, the diagnosis of SVC obstruction may remain undiagnosed. In the present case, the presence of SVC thrombosis was purely coincidental. In fact, the obstruction was first noticed on diagnostic tests performed because of the malfunction of a totally implantable Porth a Cath placed into the superior vena cava (through right subclavian access), five years before, in a patient suffering from non-Hodgkin disease. Venography is the most appropriate diagnostic methodology which reveals the presence of a dilated azygos vein as a compensatory mechanism. Comparison with computed tomography allows to confirm the diagnosis and to identify the possible causes. Dilatation of the azygos vein, secondary to superior vena cava thrombosis, although a rare event, should be taken into consideration in those patients with CVC and who present with frequent episodes of deep venous thrombosis.


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Conventional Radiography, Angiography, Interventional, Computed Tomography

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Thoraco-abdominal Aorta Dissection: Look Again Before You Leap by Abdel-Rauf Zeina et al.

Published: 2009 Sep
Issue: 3(9) :: Pages: 29-33


Free full text article: Thoraco-abdominal Aorta Dissection: Look Again Before You Leap

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Abstract: Aortic dissection is a life-threatening condition that might require immediate assessment and therapy. We present the case of a 71-year-old woman with essential hypertension complaining about low back pain; unenhanced thoracic-lumbar spine computed tomography examination (CT) revealed a hyperdense thin line across the aorta with an appearance of "double aortic lumen". Enhanced CT scan confirmed the diagnosis of type B aortic dissection. Radiologists should be familiar with this finding that could be considered a new radiological sign of aortic dissection on unenhanced CT examination.


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Computed Tomography, Magnetic Resonance Imaging, Ultrasound

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Fatal Bleeding Disorder as the First Manifestation of a Giant Aortic Aneurysm by Natalia Vallianou et al.

Published: 2009 Jun
Issue: 3(6) :: Pages: 38-40


Free full text article: Fatal Bleeding Disorder as the First Manifestation of a Giant Aortic Aneurysm

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Abstract: Aortic aneurysms are a rare cause of consumption coagulopathy. We describe an 82-year old woman with a previously unrecognized giant aneurysm of the thoracic aorta. The first manifestation of this condition was hemoptysis that was due to an exacerbation of chronic disseminated intravascular coagulation. The patient eventually died despite intensive conservative treatment, as she declined late surgical intervention. This case underscores the need to exclude aortic aneurysms by performing a chest X-ray in elderly patients with bleeding disorders.


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Conventional Radiography, Computed Tomography

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Solitary fibrous tumor of pleura: a case report and review of clinical, radiographic and histologic findings by Vishal K. Agarwal et al.

Published: 2009 May
Issue: 3(5) :: Pages: 16-20


Free full text article: Solitary fibrous tumor of pleura: a case report and review of clinical, radiographic and histologic findings

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Abstract: We present a case of solitary fibrous tumor of pleura (SFTP) in a 63-year-old male. Clinical manifestations of this entity, including paraneoplastic syndromes, are discussed, albeit absent in our presented case. Furthermore radiographic findings and pathologic correlations are provided. SFTP remains a rare neoplasm for which radiographic features are suggestive yet nonspecific, and immunohistochemistry remains as the diagnostic method of choice.


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Conventional Radiography, Computed Tomography, Microscopic pathology

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Metastatic Pulmonary Calcification in a Patient with Chronic Renal Failure by Ozlem Alkan et al.

Published: 2009 Apr
Issue: 3(4) :: Pages: 14-17


Free full text article: Metastatic Pulmonary Calcification in a Patient with Chronic Renal Failure

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Abstract: Metastatic pulmonary calcification characterized by diffuse calcium deposition in the lungs is known to occur in patients with chronic renal failure. We present a case of a 47-year-old man with chronic renal failure presented with dyspnea, high-resolution computed tomography of the chest revealed multiple, centrilobular, calcified nodules and patchy areas of ground-glass opacity throughout both lungs, consistent with metastatic pulmonary calcification. Calcification was also seen in the bronchi and trachea.


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Conventional Radiography, Computed Tomography

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Diagnosis of Variants of Single Right Coronary Trunk Using 64 Multidetector Computed Tomography by Ashley E. Kempf et al.

Published: 2008 Nov
Issue: 2(5) :: Pages: 19-22


Free full text article: Diagnosis of Variants of Single Right Coronary Trunk Using 64 Multidetector Computed Tomography

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Abstract: Single coronary anomalies are one of the rarest variants of coronary anatomy. Widespread use of coronary CT angiography has made it possible to diagnose these variants with increasing incidence. We report two cases of single right coronary trunk with different anatomic course of the left coronary artery; one anterior to the main pulmonary artery and the second between the main pulmonary artery and ascending aorta and then coursing within the interventricular septum.


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Computed Tomography





Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Apneic oxygenation for elimination of respiratory motion artefact in an intubated patient undergoing helical computed tomography pulmonary angiography by Christos Dragoumanis et al.

Published: 2008 Oct
Issue: 2(4) :: Pages: 5-7


Free full text article: Apneic oxygenation for elimination of respiratory motion artefact in an intubated patient undergoing helical computed tomography pulmonary angiography

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Abstract: Respiratory motion artifact in intubated and mechanically ventilated patients often reduces the quality of helical computed tomography pulmonary angiography (CTPA). Apneic oxygenation is a well established intra-operative technique that allows adequate oxygenation for short periods (up to 10 min) in sedated and paralyzed patients. We describe the use of the apneic oxygenation for elimination of respiratory motion artefact in an intubated patient undergoing CTPA.


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Graph, Computed Tomography

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Cavitating Lung Lesions in Chronic Thromboembolic Pulmonary Hypertension by Heather Harris et al.

Published: 2008 Sep
Issue: 2(3) :: Pages: 11-21


Free full text article: Cavitating Lung Lesions in Chronic Thromboembolic Pulmonary Hypertension

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Abstract: Purpose: The aim of this study is to assess the incidence and natural history of cavitating lung lesions in chronic thromboembolic pulmonary hypertension (CTEPH), note thrombus position between patients with and without a cavity and determine whether their development is a predictor of mortality. Materials & Methods: All patients with confirmed CTEPH attending our Pulmonary Vascular Unit between February 1998 and January 2006 were identified, and a review of their notes and imaging was performed. Thrombus position, pre-disposing factors, cavity progression and mortality were noted, and comparisons made between those with and without a cavity. Results: 11 of 104 patients had a cavity (10.6%). Thrombus distribution was similar between those with and those without a cavity. Preceding infection was not proven in most cases. 27.3% of patients with a cavity died compared to 26.8% of those without. Conclusion: Cavity formation in CTEPH is 3 times more common than in acute pulmonary embolism. Thrombus position does not predict cavity development, and the presence of a cavity may serve as an indicator of disease severity but does not appear to predict mortality.


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Computed Tomography, Magnetic Resonance Imaging, Conventional Radiography, Table

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Other Radiology articles from the Thoracic Radiology section Thoracic Radiology

Thoracic peri-aortic fibrosis in a patient of psoriasis – Cyclosporine as a putative etiologic agent by Nitin P Ghonge et al.

Published: 2008 Sep
Issue: 2(3) :: Pages: 22-24


Free full text article: Thoracic peri-aortic fibrosis in a patient of psoriasis – Cyclosporine as a putative etiologic agent

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Abstract: The article describes an unusual occurrence of peri-aortic fibrosis with consequent luminal stenosis in descending thoracic aorta in an adult case of Psoriasis. The report also illustrates the role of Multi-detector CT in the diagnosis of thoracic peri-aortic fibrosis. The patient had received cyclosporine on multiple occasions during acute exacerbation of disease. In absence of any concomitant infective-inflammatory system disorder or atherosclerotic process, the cyclosporine is suggested as a putative etiologic agent for peri-aortic fibrosis.


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Macroscopic pathology, Computed Tomography

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Pulmonary Embolism following Endovenous Laser Ablation (EVLA) of the Great Saphenous Vein by Nnamdi Nwaejike et al.

Published: 2008 Aug
Issue: 2(2) :: Pages: 9-12


Free full text article: Pulmonary Embolism following Endovenous Laser Ablation (EVLA) of the Great Saphenous Vein

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Abstract: A 70yr old lady presented to accident and emergency with sudden onset pleuritic chest pain. A pulmonary embolus (PE) was diagnosed by CTPA. Ten days earlier she had bilateral EVLA for recurrent great saphenous vein disease. Confounding risk factors for pulmonary embolism included bilateral ligation and stripping of the great saphenous vein a year earlier, malignancy, EVLA and phlebitic tributary varices. EVLA has been shown to be an effective treatment for superficial venous insufficiency with low morbidity and high patient satisfaction. The investigation of confounding risk factors and possible causes should not compromise the initial treatment of PE.


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Intraoperative, Conventional Radiography, Computed Tomography, Nuclear Medicine

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