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5.  Influenza A (H1N1) pneumonia: HRCT findings*  
OBJECTIVE:
To describe aspects found on HRCT scans of the chest in patients infected with the influenza A (H1N1) virus.
METHODS:
We retrospectively analyzed the HRCT scans of 71 patients (38 females and 33 males) with H1N1 infection, confirmed through laboratory tests, between July and September of 2009. The HRCT scans were interpreted by two thoracic radiologists independently, and in case of disagreement, the decisions were made by consensus.
RESULTS:
The most common HRCT findings were ground-glass opacities (85%), consolidation (64%), or a combination of ground-glass opacities and consolidation (58%). Other findings were airspace nodules (25%), bronchial wall thickening (25%), interlobular septal thickening (21%), crazy-paving pattern (15%), perilobular pattern (3%), and air trapping (3%). The findings were frequently bilateral (89%), with a random distribution (68%). Pleural effusion, when observed, was typically minimal. No lymphadenopathy was identified.
CONCLUSIONS:
The most common findings were ground-glass opacities and consolidations, or a combination of both. Involvement was commonly bilateral with no axial or craniocaudal predominance in the distribution. Although the major tomographic findings in H1N1 infection are nonspecific, it is important to recognize such findings in order to include infection with the H1N1 virus in the differential diagnosis of respiratory symptoms.
doi:10.1590/S1806-37132013000300009
PMCID: PMC4075839  PMID: 23857688
Pneumonia, viral; Tomography, X-ray computed; Influenza A virus, H1N1 subtype
13.  Cavitated Conglomerate Mass in Silicosis Indicating Associated Tuberculosis 
Case Reports in Medicine  2010;2010:293730.
Silicosis is the most common occupational lung disease worldwide. It leads to respiratory impairment and may have associated infections that decrease pulmonary function. We describe the case of a 55-year-old man with chronic silicosis who presented with hemoptysis and a cavitated conglomerate mass. The final diagnosis was silicotuberculosis.
doi:10.1155/2010/293730
PMCID: PMC2929613  PMID: 20811560
14.  Pulmonary Alveolar Microlithiasis: A Case Report with Emphasis on Imaging Findings 
Case Reports in Medicine  2010;2010:819242.
Pulmonary alveolar microlithiasis (PAM) is a rare disease characterized by the presence of small calculi in the alveolar space. The authors report a case of a 21-year-old man with a 2-year history of shortness of breath on exertion and dry cough. Physical examination was altered only for crackles at auscultation. Pulmonary function revealed a mild restrictive ventilatory defect and the chest radiograph demonstrated paracardiac confluence of dense micronodular infiltrate. High-resolution CT scan revealed diffuse ground glass attenuation and septal thickening, more pronounced in lower pulmonary regions, with calcifications along the interlobar septa and subpleural regions. A transbronchial lung biopsy confirmed the diagnosis of PAM.
doi:10.1155/2010/819242
PMCID: PMC2910500  PMID: 20671919
15.  Sclerosing Variant of the Bronchioloalveolar Carcinoma: Imaging Findings in an Atypical Case 
Case Reports in Medicine  2010;2010:361265.
Bronchioloalveolar carcinoma remains one of the most enigmatic lung cancers, demonstrating varied growth patterns, mixed histological features, and confusing clinical manifestations. This paper reports a case of an unusual form of presentation: a sclerosing type associated with desmoplastic reaction and cicatrization. A 75-year-old woman was admitted with persistent dry cough and progressive dyspnea. Physical examination showed bilateral inspiratory crackles. A chest radiograph and high-resolution computed tomography demonstrated confluent airspace nodules, forming areas of consolidation in both lungs, with signs of architectural distortion. The lung biopsy revealed a nonmucinous sclerosing bronchioloalveolar carcinoma.
doi:10.1155/2010/361265
PMCID: PMC2892667  PMID: 20589217
16.  Spontaneous Pneumothorax as an Atypical Presentation of Pulmonary Paracoccidioidomycosis: A Case Report with Emphasis on the Imaging Findings 
Case Reports in Medicine  2010;2010:961984.
We describe the case of a 45-year-old male with pulmonary paracoccidioidomycosis and spontaneous pneumothorax. The patient presented to the hospital with sudden and intense chest pain accompanied by dyspnea and had a six-month history of dry cough, weight loss, and progressive dyspnea on exertion. Chest X-ray showed a small right pneumothorax, bilateral nonhomogeneous opacities, and emphysematous areas in the lung base. Chest computed tomography showed consolidation in both lungs, with architectural distortion, nodules, interlobular septal thickening, and emphysema, in addition to the right pneumothorax. A lung biopsy revealed yeast consistent with Paracoccidioides brasiliensis. No drainage was needed, and the lung was re-expanded. The patient was treated with antifungal drugs, showed mild improvement, and was referred to outpatient care.
doi:10.1155/2010/961984
PMCID: PMC2892705  PMID: 20592996
17.  Hyalinizing Granuloma: An Unusual Case of a Pulmonary Mass 
Case Reports in Medicine  2010;2010:984765.
We describe the case of pulmonary hyalinizing granuloma in a 34-year-old asymptomatic man who presented with a pulmonary nodule apparent by chest radiography and computed tomography (CT). He had a history of previous treatment for tuberculosis. His laboratory data were normal. Bronchoscopy and CT-guided percutaneous transthoracic fine needle aspiration cytology were inconclusive. The diagnosis was revealed after the histopathological examination of an open lung biopsy.
doi:10.1155/2010/984765
PMCID: PMC2892707  PMID: 20592998
18.  Medullary Thyroid Carcinoma with Micronodular Lung Metastases: A Case Report with an Emphasis on the Imaging Findings 
Case Reports in Medicine  2010;2010:616580.
Medullary thyroid carcinoma is a rare malignancy that arises from calcitonin-producing C-cells and frequently metastasizes to lymph nodes in the neck. Distant metastases may involve bone, lung, and liver. The infrequent number of cases limits the clinical nature and ability to optimize diagnostic tools. Here, we present a case of a micronodular radiographic pattern in metastatic medullary thyroid cancer in order to enhance awareness of the disease process. A case discussion and relevant review of the literature are provided.
doi:10.1155/2010/616580
PMCID: PMC2872764  PMID: 20490356
19.  Colon Mucinous Adenocarcinoma in Childhood: A Case Report with Emphasis on Image Findings 
Case Reports in Medicine  2010;2010:327634.
Colorectal cancer is extremely rare in children. We report a case of a 12-year-old boy who presented with a five-month history of weight loss and anorexia, associated with vomiting episodes, dizziness, fatigue, and dyspnea. On physical examination, a palpable abdominal mass was noticed on the right hypochondrium and flank. An imaging study was performed, which showed a solid mass on the right colon. The patient underwent incisional surgical biopsy, and subsequent histopathologic analysis revealed a colon mucinous adenocarcinoma.
doi:10.1155/2010/327634
PMCID: PMC2847379  PMID: 20369060
20.  Paravertebral Mass in a Patient with Hemolytic Anemia: Computed Tomographic Findings 
Case Reports in Medicine  2010;2010:724279.
Extramedullary hematopoiesis is characterized by the presence of hematopoietic tissue outside of the bone marrow and is typically associated with chronic hemolytic anemias. Intrathoracic extramedullary hematopoiesis is a rare and usually asymptomatic condition. The authors report a case of a 57-year-old man with intrathoracic extramedullary hematopoiesis and hereditary spherocytosis. Clinical and laboratory evaluation, together with radiological findings, are described. The diagnosis of the disease was confirmed by tissue biopsy.
doi:10.1155/2010/724279
PMCID: PMC2846347  PMID: 20368781
22.  Tuberous sclerosis with pulmonary lymphangioleiomyomatosis and renal angiomyolipomas. Computed tomographic findings: a case report 
Cases Journal  2009;2:9124.
The authors describe a case of a 31-year-old female with tuberous sclerosis, a genetic, rare, variably expressed disease. Clinical symptoms were chest pain, and progressive dyspnea. Computed tomography scan of the chest showed bilateral, diffuse, small thin-walled cysts scattered throughout the lungs characteristic for pulmonary lymphangioleiomyomatosis. Computed tomography scan of the abdomen revealed enlarged, heterogeneous kidneys, with low density tumors corresponding to angiomyolipomas. Pulmonary lymphangioleiomyomatosis and bilateral renal angiomyolipomas are some presentations of tuberous sclerosis and the coexistence of both conditions may cause devastating morbidity and mortality.
doi:10.1186/1757-1626-2-9124
PMCID: PMC2803921  PMID: 20062701
23.  Sternal metastasis as an initial presentation of renal cell carcinoma: a case report 
Cases Journal  2009;2:9045.
Renal cell carcinoma accounts for 85% of all solid renal tumors in adults. Nearly one quarter of patients has distant metastasis at presentation while another 50% develop metastasis during follow-up. A small percentage of these are solitary metastasis. We report here a case of solitary bone sternal metastasis as an initial presentation of clear-cell renal cell carcinoma in a 56-year-old woman. The prognosis for patients with metastasized renal cell carcinoma is poor; treatment of metastasis is usually palliative and designed to provide comfort and pain relief. Palliative nephrectomy may be considered for control of symptoms. Radical nephrectomy associated with metastatic bone tumor resection is being tested to improve functional status and survival, especially when metastasis involves supporting bones.
doi:10.4076/1757-1626-2-9045
PMCID: PMC2769487  PMID: 19918357
24.  Pulmonary amyloidosis with calcified nodules and masses - a six-year computed tomography follow-up: a case report 
Cases Journal  2009;2:6540.
Introduction
Pulmonary amyloidosis is an uncommon disease, characterized by extracellular deposition of fibrillary protein in the lungs. It appears in three forms: tracheobronchial, nodular pulmonary, and alveolar septal. There are few reports of long-term observation of primary pulmonary amyloidosis.
Case presentation
We present the case of a 47-year-old man who presented with fever, dyspnea, cough and hemoptysis. Chest radiograph and computed tomography revealed multiple pulmonary nodules and masses. The patient underwent open lung biopsy, which diagnosed pulmonary amyloidosis.
Conclusion
Pulmonary nodular amyloidosis should be considered in the differential diagnosis of pulmonary nodules or masses.
doi:10.4076/1757-1626-2-6540
PMCID: PMC2769299  PMID: 19918529
25.  Pulmonary metastases from primary hepatocellular carcinoma in a 26-year-old patient: a case report 
Cases Journal  2009;2:6256.
Hepatocellular carcinoma is a primary tumor of the liver, which usually develops in the setting of chronic liver disease, particularly viral hepatitis. The diagnosis of hepatocellular carcinoma can be difficult, and often requires the use of serum markers, one or more imaging modalities, and histological confirmation. The authors describe a case of a 26-year-old woman with hepatocellular carcinoma and multiple pulmonary metastases. She presented with hepatomegaly and sporadic fever, and had negative hepatitis serology, normal alkaline phosphatase, and a rising serum alpha-fetoprotein level. The diagnosis was confirmed by histopathology, after percutaneous liver biopsy. Although the patient was in good health condition and had few symptoms, there was no possibility of treatment due to the extension of the liver tumor and the number of pulmonary metastases.
doi:10.4076/1757-1626-2-6256
PMCID: PMC2769276  PMID: 19918566

Results 1-25 (33)