Manifestations thoraciques des maladies de Behçet et de Takayasu

Imaging Features of Behçet’s Disease

“…Thoracic involvement in BD ranges from 1 to 8% and is prevalent in young men (Hamzaoui and Hamzaoui 2005;Castaner et al 2010). It consists of a wide spectrum of manifestations affecting the lung parenchyma, pleura, and extravascular mediastinal structures in addition to the lesions of vasculoBehçet affecting the vascular structures of the thorax.…”

“…It consists of a wide spectrum of manifestations affecting the lung parenchyma, pleura, and extravascular mediastinal structures in addition to the lesions of vasculoBehçet affecting the vascular structures of the thorax. Clinically, thoracic involvement can be asymptomatic or revealed by thoracic pain, dyspnea, cough, or hemoptysis (secondary to pulmonary artery vasculitis, or bronchial artery involvement), pulmonary artery thrombosis with infarction, or parenchymal hemorrhage (Lê Thi Huong et al 1996;Hamzaoui and Hamzaoui 2005). Bronchoalveolar washing can contribute to the diagnosis of BD by showing a specific lymphocytic alveolitis with increased fibronectin, hyaluronic acid, endothelin level (marker of vascular and parenchymatous reorganisation), lymphocytosis of about 30%, discrete neutrophilia, and a high ratio CD4/CD8 (Hamzaoui and Hamzaoui 2005).…”

“…Clinically, thoracic involvement can be asymptomatic or revealed by thoracic pain, dyspnea, cough, or hemoptysis (secondary to pulmonary artery vasculitis, or bronchial artery involvement), pulmonary artery thrombosis with infarction, or parenchymal hemorrhage (Lê Thi Huong et al 1996;Hamzaoui and Hamzaoui 2005). Bronchoalveolar washing can contribute to the diagnosis of BD by showing a specific lymphocytic alveolitis with increased fibronectin, hyaluronic acid, endothelin level (marker of vascular and parenchymatous reorganisation), lymphocytosis of about 30%, discrete neutrophilia, and a high ratio CD4/CD8 (Hamzaoui and Hamzaoui 2005). Radiologically, the chest X-ray is useful for initial assessment of thoracic signs of BD, but CT is the best tool to demonstrate the entire spectrum of the thoracic manifestations of the disease (Hiller et al 2004).…”

“…Renewed hemorrhagic episodes may induce a reticular pattern (Fig. 38) and gradually the appearance of interstitial fibrosis develops, related to pulmonary hemosiderosis (Hiller et al 2004; Hamzaoui and Hamzaoui 2005;Castaner et al 2010). Pulmonary infarction appears as subpleural, nodular or triangular opacities often located in the lower lobes with a peripheral large base (Fig.…”

“…39). It may take a pseudo-tumoral aspect when it is not based on a tangential pleural surface and may become cavitated (Lê Thi Huong et al 1996;Hamzaoui and Hamzaoui 2005). Pneumonia may also occur in patients with BD.…”