Chest CT findings and clinical features in mild Legionella pneumonia.

OBJECTIVE: To evaluate mild Legionella pneumonia (LP) by chest CT, and clinical features. PATIENTS: In June 2000, an outbreak of LP occurred in Japan. Eight patients with mild LP (seven men, one woman; mean age 55.9 years) had fevers of more than 38 degrees C, but respiratory symptoms were observed only in four. Chest CT was performed before starting an appropriate treatment. MEASUREMENT: CT images were assessed by the distribution of ground-glass opacity (GGO), consolidation, and the existence of pleural effusion. RESULTS: Chest CT findings: multiple segments were affected in all of the patients, (pleural effusion in three, peripheral lung consolidation in seven, and GGO in seven). GGO was located around the consolidation in six patients. CONCLUSION: Mild LP may present as fever without respiratory symptoms. Chest CT findings of mild LP are bilateral, multiple affected segments and peripheral lung consolidation with GGO.

Intralobar pulmonary sequestration presenting increased serum CA19-9 and CA125.

A 39-year-old man was admitted to our hospital for further evaluation of a consolidated shadow and clarification of the cause of serum tumor marker elevation (CA19-9 496.2 U/ml, CA125 160.6 U/ml). Chest computed tomography revealed a well-defined homogeneous nodule in the left S(10). Angiography showed one aberrant artery, branching from the ascending aorta. Intralobar pulmonary sequestration was diagnosed and the sequestrated lung was resected. Microscopic findings of the sequestrated lung showed a mucus-containing cystically dilated bronchus, which was covered with ciliated cylindrical epithelium. Immunohistochemical staining showed positive staining for CA19-9 and CA125 in both the ciliated cylindrical epithelium and mucus. Serum values of tumor markers returned to their normal range after surgery.