Thin-section CT assessment of spontaneous pneumomediastinum in interstitial lung disease: Correlation with serial changes in lung parenchymal abnormalities

Matsuoka, Shin; Kurihara, Yasuyuki; Yagihashi, Kunihiro; Okamoto, Kazushi; Niimi, Hiroshi; Nakajima, Yasuo

doi:10.1016/j.rmed.2005.04.016

Cited by 16 publications

(13 citation statements)

References 28 publications

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“…Matsuoka et al (17) described significant decrease in the extent of opacification in patients who received either corticosteroids or immunosuppressive agents for ILD at the time their pneumomediastinums were detected when the CT images were compared with CT images taken before these patients developed pneumomediastinum. Progressions of honeycombing scores were not evident in our case when pneumomediastinum was diagnosed.…”

Section: Discussionmentioning

confidence: 99%

A Fatal Complication of Dermatomyositis: Spontaneous Pneumomediastinum

Cetinoglu¹,

Dalkılıç²,

Erol³

et al. 2016

Eurasian J Pulmonol

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Section: Discussionmentioning

confidence: 99%

A Fatal Complication of Dermatomyositis: Spontaneous Pneumomediastinum

Cetinoglu¹,

Dalkılıç²,

Erol³

et al. 2016

Eurasian J Pulmonol

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“…It is noteworthy that the majority of the patients with concomitant pneumomediastinum were receiving corticosteroids for underlying lung disease. Matsuoka et al reviewed computed tomography images before and at the time of detection of pneumomediastinum in patients with ILD and reported that pneumomediastinum had developed in the patients receiving corticosteroids despite the decrease of lung opacities including ground-glass opacity and consolidation (28). Therefore, corticosteroid use may be associated with the development of pneumomediastinum.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Blood-Patch Pleurodesis for Secondary Spontaneous Pneumothorax in Interstitial Lung Disease

et al. 2011

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Objective We identified the prognostic relevance of pneumothorax in interstitial lung disease (ILD) patients and evaluated the efficacy and safety of autologous blood-patch pleurodesis. Methods We retrospectively reviewed 59 occurrences of pneumothorax in 34 ILD patients identified over a 12-year period. Results Air leakage ceased in 16 of 22 (72.7%) episodes after blood pleurodesis and in 11 of 14 (78.6%) episodes after chemical pleurodesis. Both the cure ratio and recurrence ratio in the cure episodes were comparable with those in the chemical pleurodesis group (p=0.99 and 0.99, respectively). In addition, there were no harmful events associated with blood pleurodesis. The median survival time after the first episode of pneumothorax was less than 9 months in patients with idiopathic interstitial pneumonia (IIP) and only around 3 years in the patients with other types of ILD, which have essentially favorable outcomes. Kaplan-Meier survival estimates were significantly worse in the patients with concomitant pneumomediastinum than in those without (p<0.05). A multivariate Cox regression analysis identified that the number of episodes of pneumothorax, IIP diagnosis and concomitant pneumomediastinum were independent predictors of death. Conclusion Autologous blood-patch pleurodesis is safe and worth considering as a first-line treatment for pneumothorax secondary to ILD. However, despite treatments, the prognosis after the onset of pneumothorax in ILD patients was found to be poor. In addition, concomitant pneumomediastinum may further worsen the prognosis.

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“…One report suggested that the use of corticosteroids for the treatment of underlying diseases weakens the interstitial lung tissues, 7 while another suggested that spontaneous pneumomediastinum occurs if steroid or immunosuppressant therapy is not administered to patients on worsening of their condition. 8 All these reports focused on air leaks as the underlying pathology.…”

Section: Discussionmentioning

confidence: 99%

Mediastinal vacuum phenomenon: atypical pneumomediastinum caused by gas replacement of diminished fat

Hagiwara¹,

Torii²

2015

IMCRJ

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We report a case involving an 83-year-old man with interstitial lung disease who developed atypical pneumomediastinum caused by gas replacement of diminished fat. The patient presented with a complaint of worsening symptoms of respiratory difficulty since a diagnosis of chronic eosinophilic pneumonia 5 months back. He had been under observation with no particular treatment for 5 months. Computed tomography performed on admission revealed pneumomediastinum. When the current scan was compared with that obtained 5 months ago, it was evident that the fat surrounding the mediastinum had been replaced by gas density. There was no mediastinal enlargement, pneumothorax, or pneumopericardium. Because the patient was elderly, home oxygen therapy was initiated for the interstitial pneumonia with no steroid therapy. Computed tomography performed 10 months after discharge showed the reappearance of mediastinal fat and no evidence of gas density. This case is unique because the pneumomediastinum was distinct from spontaneous pneumomediastinum caused by alveolar air leaks and resembled the vacuum phenomenon caused by intervertebral disc degeneration.

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Thin-section CT assessment of spontaneous pneumomediastinum in interstitial lung disease: Correlation with serial changes in lung parenchymal abnormalities

Abstract: Spontaneous pneumomediastinum associated with interstitial lung disease appears to have a tendency to occur under conditions of altered of parenchymal interstitial lesions.

Cited by 16 publications

References 28 publications

A Fatal Complication of Dermatomyositis: Spontaneous Pneumomediastinum

A Fatal Complication of Dermatomyositis: Spontaneous Pneumomediastinum

Efficacy of Blood-Patch Pleurodesis for Secondary Spontaneous Pneumothorax in Interstitial Lung Disease

Mediastinal vacuum phenomenon: atypical pneumomediastinum caused by gas replacement of diminished fat

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