RESUMO
Interstitial lung disease is a well-recognised manifestation and a major cause of morbidity and mortality in patients with connective tissue diseases. Interstitial lung disease may arise in the context of an established connective tissue disease or be the initial manifestation of an otherwise occult autoimmune disorder. Early detection and characterisation are paramount for adequate patient management and require a multidisciplinary approach, in which imaging plays a vital role. Computed tomography is currently the imaging method of choice; however, other imaging techniques have recently been investigated, namely ultrasound, magnetic resonance imaging, and positron-emission tomography, with promising results. The aim of this review is to describe the imaging findings of connective tissue disease-related interstitial lung disease and explain the role of each imaging technique in diagnosis and disease characterisation.
Assuntos
Doenças do Tecido Conjuntivo/diagnóstico por imagem , Diagnóstico por Imagem/métodos , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Imagem Multimodal/métodos , Doenças do Tecido Conjuntivo/complicações , Humanos , Pulmão/diagnóstico por imagem , Doenças Pulmonares Intersticiais/complicações , Imageamento por Ressonância Magnética , Tomografia por Emissão de Pósitrons , Ultrassonografia/métodosRESUMO
AIM: To assess the computed tomography (CT) findings of solitary cavitary lesions which could potentially aid in differentiating malignant from non-malignant lung disease. MATERIALS AND METHODS: A retrospective study of patients diagnosed with a solitary lung cavity at two university hospitals, who underwent multidetector CT examinations of the chest between 2012 and 2014, was performed. Lesions were evaluated for maximum diameter, maximum wall thickness, and associated findings. Statistical analyses were then conducted and a receiver operating characteristic (ROC) curve was calculated to select the most accurate cut-off value for malignant and non-malignant lesions. RESULTS: CT and clinical records from 96 patients were reviewed. The most frequent aetiologies of non-malignant and malignant lung cavities were mycobacterial infection sequelae (50%, 33/66) and primary lung carcinoma (94%, 28/30), respectively. Significant differences (p<0.05) were found between malignant and non-malignant cases when comparing the averages of maximum wall thickness (15.2 and 7.8 mm, respectively) and maximum diameter of lesions (51 and 35 mm, respectively). The presence of either perilesional consolidation or centrilobular nodules favoured the diagnosis of non-malignant conditions (p<0.05). Maximum wall thicknesses thresholds of ≤7 or ≥24 mm were the most accurate in suggesting non-malignant and malignant aetiologies, respectively. CONCLUSION: Malignant and non-malignant solitary lung cavities differ significantly at CT. Non-malignant lesions tend to exhibit thinner walls, but more perilesional consolidation and centrilobular nodules than malignant lesions. The results reveal that maximum wall thicknesses of ≤7 and ≥24 mm are indicative of non-malignant and malignant disease, respectively.
Assuntos
Nódulo Pulmonar Solitário/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Pulmão , Masculino , Pessoa de Meia-Idade , Curva ROC , Reprodutibilidade dos Testes , Estudos RetrospectivosAssuntos
Síndrome de Birt-Hogg-Dubé/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Idoso , Síndrome de Birt-Hogg-Dubé/complicações , Feminino , Humanos , Pneumopatias/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
This article reports the case of a patient demonstrating acute bilateral pneumonitis almost completely confined to the upper lobes as a result of inhaling heroin. We attribute this distribution to the patient performing the Valsalva manoeuvre immediately after inhaling heroin. This pattern has not been reported before and we believe it may be seen more frequently owing to a switch amongst drug users from intravenous to inhaled heroin.
Assuntos
Lesão Pulmonar Aguda/diagnóstico por imagem , Dependência de Heroína/complicações , Heroína/efeitos adversos , Pneumonia/diagnóstico por imagem , Radiografia Torácica , Manobra de Valsalva , Doença Aguda , Lesão Pulmonar Aguda/induzido quimicamente , Lesão Pulmonar Aguda/fisiopatologia , Administração por Inalação , Gasometria , Feminino , Heroína/farmacocinética , Humanos , Pessoa de Meia-Idade , Pneumonia/induzido quimicamente , Pneumonia/fisiopatologiaRESUMO
Drug-induced lung diseases are a frequent cause of morbidity. Diffuse pulmonary haemorrhage is an uncommon complication of drug therapy, and is a potentially life-threatening situation. We report the high-resolution CT and clinical findings of a 32-year-old man with diffuse pulmonary haemorrhage induced by ketorolac tromethamine.
Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Hemorragia/diagnóstico por imagem , Cetorolaco de Trometamina/efeitos adversos , Pneumopatias/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Hemorragia/induzido quimicamente , Humanos , Pneumopatias/induzido quimicamente , Masculino , Intensificação de Imagem RadiográficaRESUMO
A 48-year-old woman presented with cough and chest pain. A chest radiograph and CT scans showed bilateral lung masses containing massive venous varices. A core biopsy specimen revealed benign metastasising leiomyoma with strong expression of progesterone receptors. A review of her medical history revealed a hysterectomy 11 years earlier. The lung masses showed significant reduction in size after induction of artificial menopause, although the pulmonary varices persisted.