The present study was aimed at retrospectively reviewing high-resolution computed
tomography (HRCT) findings in patients with pulmonary alveolar microlithiasis in
order to evaluate the frequency of tomographic findings and their distribution in
the lung parenchyma.
Materials and Methods
Thirteen patients (9 females and 4 males; age, 9 to 59 years; mean age, 34.5
years) were included in the present study. The HRCT images were independently
evaluated by two observers whose decisions were made by consensus. The inclusion
criterion was the presence of abnormalities typical of pulmonary alveolar
microlithiasis at HRCT, which precludes lung biopsy. However, in 6 cases lung
biopsy was performed.
Ground-glass opacities and small parenchymal nodules were the predominant
tomographic findings, present in 100% of cases, followed by small subpleural
nodules (92.3%), subpleural cysts (84.6%), subpleural linear calcifications
(69.2%), crazy-paving pattern (69.2%), fissure nodularity (53.8%), calcification
along interlobular septa (46.2%) and dense consolidation (46.2%).
As regards distribution of the lesions, there was preferential involvement of the
lower third of the lungs. No predominance of distribution in axial and
anteroposterior directions was observed.
Pulmonary alveolar microlithiasis; High-resolution computed tomography; Pulmonary calcifications
To evaluate HRCT scans of the chest in 22 patients with cocaine-induced pulmonary disease.
We included patients between 19 and 52 years of age. The HRCT scans were evaluated by two radiologists independently, discordant results being resolved by consensus. The inclusion criterion was an HRCT scan showing abnormalities that were temporally related to cocaine use, with no other apparent causal factors.
In 8 patients (36.4%), the clinical and tomographic findings were consistent with "crack lung", those cases being studied separately. The major HRCT findings in that subgroup of patients included ground-glass opacities, in 100% of the cases; consolidations, in 50%; and the halo sign, in 25%. In 12.5% of the cases, smooth septal thickening, paraseptal emphysema, centrilobular nodules, and the tree-in-bud pattern were identified. Among the remaining 14 patients (63.6%), barotrauma was identified in 3 cases, presenting as pneumomediastinum, pneumothorax, and hemopneumothorax, respectively. Talcosis, characterized as perihilar conglomerate masses, architectural distortion, and emphysema, was diagnosed in 3 patients. Other patterns were found less frequently: organizing pneumonia and bullous emphysema, in 2 patients each; and pulmonary infarction, septic embolism, eosinophilic pneumonia, and cardiogenic pulmonary edema, in 1 patient each.
Pulmonary changes induced by cocaine use are varied and nonspecific. The diagnostic suspicion of cocaine-induced pulmonary disease depends, in most of the cases, on a careful drawing of correlations between clinical and radiological findings.
Cocaine, Cocaine-related disorders; Tomography, X-ray computed; Lung diseases
To determine the frequency of HRCT findings and their distribution in the lung parenchyma of patients with organizing pneumonia.
This was a retrospective review of the HRCT scans of 36 adult patients (26 females and 10 males) with biopsy-proven organizing pneumonia. The patients were between 19 and 82 years of age (mean age, 56.2 years). The HRCT images were evaluated by two independent observers, discordant interpretations being resolved by consensus.
The most common HRCT finding was that of ground-glass opacities, which were seen in 88.9% of the cases. The second most common finding was consolidation (in 83.3% of cases), followed by peribronchovascular opacities (in 52.8%), reticulation (in 38.9%), bronchiectasis (in 33.3%), interstitial nodules (in 27.8%), interlobular septal thickening (in 27.8%), perilobular pattern (in 22.2%), the reversed halo sign (in 16.7%), airspace nodules (in 11.1%), and the halo sign (in 8.3%). The lesions were predominantly bilateral, the middle and lower lung fields being the areas most commonly affected.
Ground-glass opacities and consolidation were the most common findings, with a predominantly random distribution, although they were more common in the middle and lower thirds of the lungs.
Cryptogenic organizing pneumonia; Respiratory tract diseases; Tomography, X-ray computed
The aim of this study was to analyze chest CT scans of patients with thoracic
This was a retrospective study of 16 patients (11 men and 5 women) with
surgically confirmed thoracic textiloma. The chest CT scans of those patients were
evaluated by two independent observers, and discordant results were resolved by
The majority (62.5%) of the textilomas were caused by previous heart surgery. The
most common symptoms were chest pain (in 68.75%) and cough (in 56.25%). In all
cases, the main tomographic finding was a mass with regular contours and borders
that were well-defined or partially defined. Half of the textilomas occurred in
the right hemithorax and half occurred in the left. The majority (56.25%) were
located in the lower third of the lung. The diameter of the mass was ≤ 10 cm in 10
cases (62.5%) and > 10 cm in the remaining 6 cases (37.5%). Most (81.25%) of
the textilomas were heterogeneous in density, with signs of calcification, gas,
radiopaque marker, or sponge-like material. Peripheral expansion of the mass was
observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used.
Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and
pericardial involvement was observed in 2 (12.5%).
It is important to recognize the main tomographic aspects of thoracic textilomas
in order to include this possibility in the differential diagnosis of chest pain
and cough in patients with a history of heart or thoracic surgery, thus promoting
the early identification and treatment of this postoperative complication.
Foreign-body reaction; Tomography; spiral computed; Thoracic surgery