The presence of large nodules and visualization of the halo sign are most suggestive of fungal infection. Other high-resolution CT patterns are not helpful in distinguishing among the various types of infection seen in bone marrow transplant recipients.
Bone marrow transplant recipients have increased prevalence of viral infections, including Herpes simplex pneumonia. The majority of infections are due to HSV type 1. We report the high-resolution CT findings in 3 bone marrow transplant patients with herpes simplex type 2 pneumonia. The most common CT features were focal areas of consolidation seen in 3 patients, and small centrilobular nodules and areas of ground-glass attenuation seen in 2 patients.
OBJETIVO: Descrever os achados de tomografia computadorizada de alta resolução de pacientes com esclerose sistêmica pulmonar, independentemente dos sintomas respiratórios. MATERIAIS E MÉTODOS: Foram revisados 73 exames de tomografia computadorizada de alta resolução de 44 pacientes com diagnós-tico de esclerodermia estabelecido através de critérios clínicos e laboratoriais. Os exames foram revisados por dois radiologistas, que estabeleceram os achados por consenso. RESULTADOS: Em 91,8% (n = 67) dos exames observaram-se alterações. Os principais achados foram lesões de padrão reticular (90,4%), opacidades em vidro-fosco (63%), bronquiectasias e bronquiolectasias de tração (56,2%), dilatação esofagiana (46,6%), faveolamento (28,8%) e sinais de hipertensão pulmonar (15,6%). Na maioria dos casos as lesões eram bilaterais (89%) e simétricas (58,5%). Quanto à localização, houve predomínio de lesões basais (91,2%) e periféricas (92,2%). CONCLUSÃO: A esclerose sistêmica progressiva acarreta fibrose pulmonar na maioria dos pacientes, caracterizada principalmente por lesão reticular basal e periférica. Unitermos: Tomografia computadorizada de alta resolução; Esclerose sistêmica pulmonar; Padrão reticular.Progressive systemic sclerosis: high-resolution computed tomography findings. OBJECTIVE: To describe the high-resolution computed tomography findings in the lung of patients with systemic sclerosis, independently of the respiratory symptoms. MATERIALS AND METHODS: Seventy-three high-resolution computed tomography scans of 44 patients with clinical diagnosis of systemic sclerosis were reviewed and defined by the consensus of two radiologists. RESULTS: Abnormalities were seen in 91.8% (n = 67) of the scans. The most frequent findings were reticular pattern (90.4%), ground-glass opacities (63%), traction bronchiectasis and bronchiolectasis (56.2%), esophageal dilatation (46.6%), honeycombing pattern (28.8%) and signs of pulmonary hypertension (15.6%). In most cases the lesions were bilateral (89%) and symmetrical (58.5%). The lesions were predominantly located in the basal (91.2%) and peripheral (92.2%) regions. CONCLUSION: In the majority of the patients, progressive systemic sclerosis can cause pulmonary fibrosis mainly characterized by reticular pattern with basal and peripheral distribution on highresolution computed tomography. Key words: High-resolution computed tomography; Progressive systemic sclerosis; Reticular pattern. Resumo Artigo OriginalA esclerose sistêmica progressiva é caracterizada por um processo auto-imune de etiologia desconhecida que resulta em vasculopatia fibrótica e acúmulo difuso de proteínas na matriz extracelular. No envolvimento pulmonar há inflamação e fibrose do interstício, alvéolos e tecido peribrôn-quico. A vasculopatia pode ocasionar hipertensão pulmonar mesmo na ausência de fibrose significativa (2) . As complicações pulmonares suplantaram o envolvimento renal como causa mais comum de morte, sendo consideradas fator prognóstico adverso da esclerodermia . Semelhantemente a outras doenças ...
Nineteen year-old female patient, who underwent bone marrow transplantation because of chronic myelogenous leukemia, presented with dry cough and coriza sixty-seven days after the procedure. The chest radiograph was normal. The high resolution computed tomography showed a subsegmental air-space consolidation at the periphery of the left inferior lobe and areas of low attenuation at the superior and middle lung zones. The bronchoalveolar lavage demonstrated positive direct fluorescence antibody testing against parainfluenza virus. Treatment with aerolizated ribavirin was instituted during 10 days and the patient showed clinical-radiological improvement.
Este relato descreve um caso de sarcoma fibromixóide de baixo grau na parede torácica em uma paciente feminina de 23 anos de idade. A radiografia de tórax e a tomografia computadorizada demonstraram massa heterogênea na região inferior do hemitórax direito, com necrose e focos de calcificação. O exame histológico foi sugestivo de leiomioma, mas a imuno-histoquímica definiu o diagnóstico de sarcoma fibromixóide de baixo grau. A evolução clínica do caso foi boa, apesar dos aspectos de malignidade demonstrados na tomografia computadorizada.
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