Rheumatoid arthritis is associated with four CT patterns: usual interstitial pneumonia, nonspecific interstitial pneumonia, bronchiolitis, and organizing pneumonia. The most common CT features of rheumatoid arthritis-related lung disease were GGO and reticulation.
Eosinophilic lung diseases are a diverse group of pulmonary disorders associated with peripheral or tissue eosinophilia. They are classified as eosinophilic lung diseases of unknown cause (simple pulmonary eosinophilia [SPE], acute eosinophilic pneumonia [AEP], chronic eosinophilic pneumonia [CEP], idiopathic hypereosinophilic syndrome [IHS]), eosinophilic lung diseases of known cause (allergic bronchopulmonary aspergillosis [ABPA], bronchocentric granulomatosis [BG], parasitic infections, drug reactions), and eosinophilic vasculitis (allergic angiitis, granulomatosis [Churg-Strauss syndrome]). The percentages of eosinophils in peripheral blood and bronchoalveolar lavage fluid are essential parts of the evaluation. Chest computed tomography (CT) demonstrates a more characteristic pattern and distribution of parenchymal opacities than does conventional chest radiography. At CT, SPE and IHS are characterized by single or multiple nodules with a surrounding ground-glass-opacity halo, AEP mimics radiologically hydrostatic pulmonary edema, and CEP is characterized by nonsegmental airspace consolidations with peripheral predominance. ABPA manifests with bilateral central bronchiectasis with or without mucoid impaction. The CT manifestations of BG are nonspecific and consist of a focal mass or lobar consolidation with atelectasis. The most common CT findings in Churg-Strauss syndrome include sub-pleural consolidation with lobular distribution, centrilobular nodules, bronchial wall thickening, and interlobular septal thickening. The integration of clinical, radiologic, and pathologic findings facilitates the initial and differential diagnoses of various eosinophilic lung diseases.
Bilateral patchy areas of opacity depicted radiographically and good clinical response to treatment may differentiate NIP from other interstitial pneumonias.
Although a mass could not be discernible by mammography because of increased radiodensity during pregnancy or lactation, calcification, asymmetric density, axillary lymphadenopathy, and skin and trabecular thickening were helpful for diagnosis of pregnancy-associated breast cancer. Sonographic findings of a solid mass with posterior acoustic enhancement and a marked cystic component were somewhat different from the appearance of breast cancer in nonpregnant women, possibly because of the physiologic changes of pregnancy and lactation.
The goal of this study was to evaluate the sonographic findings of thyroid metastases arising from non-thyroid primaries. The study over a 5-year period comprised nine patients who had histopathologically proven metastatic disease to the thyroid. Ultrasonography was available in all cases. Ultrasound-guided needle aspiration was performed on 10 suspected nodules as determined by ultrasound. The Ultrasonographic findings were analyzed in two different ways. The first analysis included only those nodules biopsed, and the second analysis included all the nodules, biopsed and non-biopsed. The primary neoplasms were breast carcinoma (n=6), uterine leiomyosarcoma (n=1), cervical carcinoma (n=1), and nasopharyngeal carcinoma (n=1). Excluding 2 nodules, the 8 remaining metastatic nodules exhibited ill-defined hypoechoic character with heterogeneous texture. The other two nodules showed relatively circumscribed iso- or hypo-echoic character with cystic portion. From the analysis of ultrasonographic findings including all thyroid nodules irrespective of pathologic proof, 7 cases - excluding the 2 cases from the 9 cases - showed unilateral or bilateral multiple nodules suspected of metastasis. There was no evidence of microcalcification in any thyroid nodules. In conclusion, the sonographic findings of the thyroid metastatic nodules were not specific, but unilateral or bilateral multiple suspected thyroid nodules without evidence of microcalcification may be suggestive of metastatic nodules among patients with a known primary non-thyroidal tumor.
Thoracic involvement occurs more frequently in systemic lupus erythematosus than in any other connective tissue diseases, and more than half of patients with the disease suffer from the involvement. Primary intrathoracic manifestations include pleural disease (effusions and/or thickening), acute lupus pneumonitis, subacute interstitial lung disease including bronchiolitis obliterans organizing pneumonia and non-specific interstitial pneumonia with fibrosis, chronic interstitial lung disease of usual interstitial pneumonia, pulmonary hemorrhage, pulmonary vascular disease, small airway disease of bronchiolitis obliterans, and pulmonary arterial hypertension. Secondary intrathoracic manifestations include atelectasis due to diaphragmatic dysfunction, opportunistic pneumonia, drug and oxygen toxicity, aspiration, and pleuropulmonary consequences of cardiac and renal failure.
The paratracheal air cysts were mostly located at the right side of the trachea and at the thoracic inlet level. One-third had communication with the trachea. Paratracheal air cysts are not associated with respiratory symptoms or obstructive lung disease clinically or radiologically.
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