Multiple cystic lung disease.

Multiple cystic lung disease represents a diverse group of uncommon disorders that can present a diagnostic challenge due to the increasing number of diseases associated with this presentation. High-resolution computed tomography of the chest helps to define the morphological aspects and distribution of lung cysts, as well as associated findings. The combination of appearance upon imaging and clinical features, together with extrapulmonary manifestations, when present, permits confident and accurate diagnosis of the majority of these diseases without recourse to open-lung biopsy. The main diseases in this group that are discussed in this review are lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis and folliculin gene-associated syndrome (Birt-Hogg-Dubé); other rare causes of cystic lung disease, including cystic metastasis of sarcoma, are also discussed. Disease progression is unpredictable, and understanding of the complications of cystic lung disease and their appearance during evolution of the disease are essential for management. Correlation of disease evolution and clinical context with chest imaging findings provides important clues for defining the underlying nature of cystic lung disease, and guides diagnostic evaluation and management.

[Acute pulmonary schistosomiasis: correlation between the high-resolution CT and pathological findings]. / Schistosomíase pulmonar aguda: Correlação entre a tomografia computadorizada de alta resolução e os achados anatomopatológicos.

A 35 years old rural worker presented with a 15 days history of progressive dyspnea, associated with dry cough, myalgia and fever. Few days before the symptoms, he had swim in a river. The chest radio- graphs demonstrated bilateral reticule-nodular infiltrates. The high-resolution CT showed patchy areas of ground-glass attenuation, irregular inter- lobular septal thickening, intralobular interstitial thickening, and small nodules, which are confluent in some regions. All the laboratory investigations were negative. The open lung biopsy shows parenchymal granulomatous inflammation, and numerous schistosome ova.

[Secondary syphilis with pulmonary involvement: report of a case with emphasis to the high-resolution CT and magnetic resonance findings]. / Sífilis secundária com comprometimento pulmonar: Relato de um caso com ênfase nos achados de tomografia computadorizada e ressonância magnética.

A 37-year-old man presented with thoracic pain and fever. The physical examination showed reddish skin lesions. He was investigated with radiography, high- resolution computed tomography and magnetic resonance of the chest, which revealed multiple small and large nodules with random distribution, mostly in the lower lungs zones. Biopsies of lung and skin lesions was performed and the diagnosis of secondary syphilis was defined. Other laboratories tests (venereal disease laboratory and FtA-abs) corroborated the diagnosis. The patient was treated with penicillin, and the pulmonary and skin lesions regressed in the follow- up examinations.

Lipoid pneumonia in children following aspiration of mineral oil used in the treatment of constipation: high-resolution CT findings in 17 patients.

BACKGROUND: Exogenous lipoid pneumonia is a rare disorder caused by aspiration of mineral, vegetable and animal oils. High-resolution CT findings of lipoid pneumonia in children taking mineral oil for constipation have been rarely reported. OBJECTIVE: To evaluate the high-resolution CT findings in 17 children with exogenous lipoid pneumonia following aspiration of mineral oil. MATERIALS AND METHODS: The study included nine boys and eight girls, with ages ranging from 2 months to 9 years. All patients underwent high-resolution CT and the images were reviewed by two radiologists who reached decisions by consensus. The inclusion criteria were an abnormal radiograph, history of taking mineral oil and the presence of intrapulmonary lipids proved by bronchoalveolar lavage or open lung biopsy. RESULTS: The most common symptoms were cough (n = 13), mild fever (n = 11), and progressive dyspnea (n = 9). The main CT findings were air-space consolidations (100%), usually with areas of fatty attenuation (70.6%), areas of ground-glass attenuation (52.9%), and a crazy-paving pattern (17.6%), predominating bilaterally in the posterior and lower regions of the lungs. CONCLUSION: The high-resolution CT features in children with exogenous lipoid pneumonia are air-space consolidations and ground-glass attenuation, occasionally with a crazy-paving pattern, distributed bilaterally in the posterior and lower zones of the lungs.