Thoracic involvement in Behçet's disease: pathologic, clinical, and imaging features.

Tunacı, Atadan; Berkmen, Yahya M.; Gökmen, Emel Sağlam

doi:10.2214/ajr.164.1.7998568

Cited by 137 publications

(113 citation statements)

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“…There were no granulomatous lesions or other findings indicating other conditions such as tuberculosis. Pleural effusion usually occurs secondary to pulmonary infarction or an infectious condition in Behçet's disease (12).…”

Section: A B Cmentioning

confidence: 99%

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A 30-year-old female Behçet’s disease patient with recurrent pleural and pericardial effusion and elevated adenosine deaminase levels: case report

et al. 2016

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Behçet's disease is a systemic disease which may involve various organs. We describe a case of a patient diagnosed as pleuropericardial involvement of Behçet's disease. A 30-year-old woman visited our clinic presented with left pleuritic chest pain for s days. She had been diagnosed as Behçet's disease and admitted to our clinic due to pericardial and pleural effusion repeatedly in past two years. In the previous studies, effusion analysis revealed to be lympho-dominant exudate with high adenosine deaminase level. Acid-fast bacilli (AFB) culture and polymerase chain reaction (PCR) for mycobacterial tuberculosis (M.TB) were negative in the pericardial tissue, and pathologic finding showed mild endothelitis with micro-thrombi formation in the lumen. The patient had been treated with antituberculous medication for a year. In the current admission, chest computed tomography (CT) again showed left pleural effusion without other significant lesion. Pleural fluid analysis was similar with the previous study. Video-assisted thoracoscopic pleural biopsy was performed to obtain the definite diagnosis. Pathology confirmed the diagnosis as pleuropericardial involvement of Behçet's disease, and we treated the patient with oral steroid in the out-patient department. Pleuropericardial involvement of Behçet's disease may mimic TB pleurisy or pericarditis due to high adenosine deaminase (ADA) level in effusion analysis. Clinicians should keep in mind that Behçet's disease may manifest as pleural or pericardial effusion, and pathologic confirmation could be helpful for the definite diagnosis.Keywords: Pleural effusion; pericardial effusion; Behçet's syndrome; adenosine deaminase Submitted Jan 06, 2016. Accepted for publication May 11, 2016May 11, . doi: 10.21037/jtd.2016 View this article at: http://dx.doi.org/10.21037/jtd.2016.05.88 J Thorac Dis 2016;8(7):E547-E551 jtd.amegroups.com syndrome or pulmonary infarction. A few case reports have indicated pleural effusion due to primary vasculitis of the pleura (6). Cardiovascular involvement, including coronary artery disease, pericarditis, myocarditis, endocarditis, arrhythmia and valvular dysfunction, have been reported in <10% of patients with Behçet's disease (9-11). Pericardial involvement, a common cardiac manifestation with up to 40% cardiac involvement, may be associated with vasculitis of the pericardium or SVC thrombosis (6,10).The main pathologic characteristic of Behçet's disease is nonspecific vasculitis of small-to-large-sized vessels in both the systemic and pulmonary circulation, with perivascular infiltration of lymphocytes and mononuclear cells (12). Vasculitis mostly affects veins and accounts for approximately 85% of the vascular involvement (3). Endothelial cell swelling, fibrinoid necrosis and thrombus formation within the vessel lumen are common in inflammation foci (5,8).Anti-inflammatory and immunosuppressive drugs represent the mainstay treatments for Behçet's disease (7,8). However, the choice of treatment varies depending on the type of organ ...

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Section: A B Cmentioning

confidence: 99%

“…The main pathologic characteristic of Behçet's disease is nonspecific vasculitis of small-to-large-sized vessels in both the systemic and pulmonary circulation, with perivascular infiltration of lymphocytes and mononuclear cells (12). Vasculitis mostly affects veins and accounts for approximately 85% of the vascular involvement (3).…”

Section: Introductionmentioning

confidence: 99%

A 30-year-old female Behçet’s disease patient with recurrent pleural and pericardial effusion and elevated adenosine deaminase levels: case report

et al. 2016

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“…Pulmonary and thoracic aortic aneurysms, arterial and venous thrombosis are the main thoracic vascular manifestations of BD [12,13]. Vascular involvement occurs in 25-30% of patients and the complications can cause death [13][14][15].…”

Section: Thoracic Vascular System Involvementmentioning

confidence: 99%

“…Vascular involvement occurs in 25-30% of patients and the complications can cause death [13][14][15]. Venous thrombosis is seen more than arterial involvement and presents 85% of vascular involvement.…”

Section: Thoracic Vascular System Involvementmentioning

confidence: 99%

“…Pericardial effusion can occur because of atelectasis, bronchitis, fibrosis and emphysema are the involvement types of lung in BD. Thrombosis of pulmonary arteries may cause infarction, atelectasis, and hemorrhage ( Figure 6) [12,13,18]. Focal or diffuse alveolar opacities, wedge-shaped consolidations, linear opacities, atelectasis, cavitary nodules, round opacities, reticulation and mosaic attenuation can be seen in the lung parenchyma ( Figure 7).…”

Section: Mediastinum and Heartmentioning

confidence: 99%

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Pulmonary and Thoracic Vascular Involvement in Behcet's Disease on CT

Damgacı¹

2017

OMICS J Radiol

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Multiple pulmonary aneurysms secondary to Hughes‐Stovin syndrome: Demonstration by MR angiography

Balci

Semelka

Noone

et al. 1998

Magnetic Resonance Imaging

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We report a case of a 41-year-old patient with multiple pulmonary aneurysms secondary to Hughes-Stovin syndrome. Conventional pulmonary angiography could not be performed, because thrombus in both the inferior and superior vena cavae prevented catheter passage. Contrast-enhanced three-dimensional (3D) MR angiography (MRA) showed two segmental pulmonary aneurysms in the right lung. The affected segments of the lung were resected successfully, predicated on the MRA findings.

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Thoracic involvement in Behçet's disease: pathologic, clinical, and imaging features.

Cited by 137 publications

References 0 publications

A 30-year-old female Behçet’s disease patient with recurrent pleural and pericardial effusion and elevated adenosine deaminase levels: case report

A 30-year-old female Behçet’s disease patient with recurrent pleural and pericardial effusion and elevated adenosine deaminase levels: case report

Pulmonary and Thoracic Vascular Involvement in Behcet's Disease on CT

Multiple pulmonary aneurysms secondary to Hughes‐Stovin syndrome: Demonstration by MR angiography

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