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Yeoh DK, McMullan BJ, Clark JE, Slavin MA, Haeusler GM, Blyth CC. The Challenge of Diagnosing Invasive Pulmonary Aspergillosis in Children: A Review of Existing and Emerging Tools. Mycopathologia 2023; 188:731-743. [PMID: 37040020 PMCID: PMC10564821 DOI: 10.1007/s11046-023-00714-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/07/2023] [Indexed: 04/12/2023]
Abstract
Invasive pulmonary aspergillosis remains a major cause of morbidity and mortality for immunocompromised children, particularly for patients with acute leukaemia and those undergoing haematopoietic stem cell transplantation. Timely diagnosis, using a combination of computed tomography (CT) imaging and microbiological testing, is key to improve prognosis, yet there are inherent challenges in this process. For CT imaging, changes in children are generally less specific than those reported in adults and recent data are limited. Respiratory sampling by either bronchoalveolar lavage or lung biopsy is recommended but is not always feasible in children, and serum biomarkers, including galactomannan, have important limitations. In this review we summarise the current paediatric data on available diagnostic tests for IPA and highlight key emerging diagnostic modalities with potential for future use.
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Affiliation(s)
- Daniel K Yeoh
- Department of Infectious Diseases, Perth Children's Hospital, 15 Hospital Avenue, Perth, WA, 6009, Australia.
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia.
- National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
- Murdoch Children's Research Institute, Parkville, VIC, Australia.
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.
| | - Brendan J McMullan
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, NSW, Australia
- School of Women's and Children's Health, UNSW, Sydney, NSW, Australia
| | - Julia E Clark
- Infection Management Service, Queensland Children's Hospital, Brisbane, QLD, Australia
- School of Clinical Medicine, Children's Health Queensland Clinical Unit, The University of Queensland, Brisbane, QLD, Australia
| | - Monica A Slavin
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia
- National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Gabrielle M Haeusler
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia
- National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Department of Infectious Diseases, Royal Children's Hospital, Parkville, VIC, Australia
- The Paediatric Integrated Cancer Service, Melbourne, VIC, Australia
| | - Christopher C Blyth
- Department of Infectious Diseases, Perth Children's Hospital, 15 Hospital Avenue, Perth, WA, 6009, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
- Department of Microbiology, PathWest Laboratory Medicine WA, Nedlands, WA, Australia
- School of Medicine, University of Western Australia, Perth, WA, Australia
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2
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Chacko SR, Matta A, Bhat R, Minimo C, Benzaquen S, Gupta E. A 62-Year-Old Immunocompromised Man With Halo Sign on Chest Imaging. Chest 2022; 162:e177-e181. [DOI: 10.1016/j.chest.2022.04.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/27/2022] [Accepted: 04/23/2022] [Indexed: 11/05/2022] Open
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Yang Y, Tan M, Ma W, Duan S, Huang X, Jin L, Tang L, Li M. Preoperative prediction of the degree of differentiation of lung adenocarcinoma presenting as sub-solid or solid nodules with a radiomics nomogram. Clin Radiol 2022; 77:e680-e688. [PMID: 35718542 DOI: 10.1016/j.crad.2022.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 05/05/2022] [Accepted: 05/19/2022] [Indexed: 11/29/2022]
Abstract
AIM To develop and validate a radiomics nomogram for prediction of degree of differentiation in lung adenocarcinoma presenting as sub-solid or solid nodules. MATERIALS AND METHODS A total of 438 patients with histopathologically confirmed adenocarcinoma (248 non-poorly differentiated and 190 poorly differentiated) were divided into training cohort (n=235) and internal validation cohort (n=203) according to surgery sequence. Sixty patients form public TCIA dataset were selected for external validation. One thousand, two hundred and eighteen radiomics features were extracted from each volumetric region of interest and a least absolute shrinkage and selection operator logistic regression was applied to select meaningful radiomic features for building a radiomics score (Rad-score) model. A nomogram model incorporating the Rad-score and type was established after multivariable logistic regression. The discrimination efficiency, calibration efficacy, and clinical utility value of the nomogram were evaluated. RESULTS The Rad-score model could predict the differentiation degree of lung adenocarcinoma with an area under the curve (AUC) of 0.83 (95% confidence interval [CI]: 0.78-0.89) in the internal validation cohort. The AUC of the nomogram and radiographic model was 0.86 (95% CI: 0.80-0.91), 0.78 (95% CI: 0.72-0.84) in the internal validation cohort respectively. The AUC of the nomogram in the external validation cohort was 0.73 (95% CI: 0.58-0.88). Delong's test showed that the nomogram performed better than radiographic features alone (p=0.001). CONCLUSIONS The proposed radiomics nomogram has the potential to predict the differentiation degree of lung adenocarcinoma preoperatively.
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Affiliation(s)
- Y Yang
- Department of Radiology, Huadong Hospital Affiliated with Fudan University, Shanghai, China
| | - M Tan
- Department of Radiology, Huadong Hospital Affiliated with Fudan University, Shanghai, China
| | - W Ma
- Department of Radiology, Huadong Hospital Affiliated with Fudan University, Shanghai, China
| | - S Duan
- GE Healthcare, Shanghai, China
| | - X Huang
- Department of Radiology, Huadong Hospital Affiliated with Fudan University, Shanghai, China
| | - L Jin
- Department of Radiology, Huadong Hospital Affiliated with Fudan University, Shanghai, China
| | - L Tang
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - M Li
- Department of Radiology, Huadong Hospital Affiliated with Fudan University, Shanghai, China.
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Swain S, Pahuja T, Ray A. Polka dot lung: classical miliary mottling in an adult. BMJ Case Rep 2022; 15:e249184. [PMID: 35393281 PMCID: PMC8990693 DOI: 10.1136/bcr-2022-249184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2022] [Indexed: 11/03/2022] Open
Affiliation(s)
- Satish Swain
- Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Taruna Pahuja
- Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Animesh Ray
- Medicine, All India Institute of Medical Sciences, New Delhi, India
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Bain V, Barrientos ACMGDA, Suzuki L, Oliveira LAND, Litvinov N, Peron KR, Fernandes JF, Marques HHDS. Radiological patterns of pulmonary fungal infection in pediatric hematology and oncology patients. Radiol Bras 2022; 55:78-83. [PMID: 35414734 PMCID: PMC8993174 DOI: 10.1590/0100-3984.2021.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/20/2021] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: To describe the radiological findings in pediatric patients with hematological or oncological diseases who also have an invasive fungal infection (IFI). Materials and Methods: This was a retrospective study of all patients with IFI admitted to a pediatric hematology and oncology hospital in Brazil between 2008 and 2014. Clinical and demographic data were collected. Chest computed tomography (CT) scans of the patients were reviewed by two independent radiologists. Results: We evaluated the chest CT scans of 40 pediatric patients diagnosed with an IFI. Twenty-seven patients (67.5%) had nodules with the halo sign, seven (17.5%) had cavities, two (5.0%) had nodules without the halo sign, and seven (17.5%) had consolidation. The patients with the halo sign and cavities were older (123 vs. 77 months of age; p = 0.03) and had less severe disease (34% vs. 73%; p = 0.04). Ten patients had a proven IFI: with Aspergillus sp. (n = 4); with Candida sp. (n = 5); or with Fusarium sp. (n = 1). Conclusion: A diagnosis of IFI should be considered in children and adolescents with risk factors and abnormal CT scans, even if the imaging findings are nonspecific.
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Mah J, Bakker A, Tseng C, Lafay-Cousin L, Kuhn S, Brundler MA, Lisboa LF. Isolated Pulmonary Emergomycosis in an Immunocompetent Patient in Alberta, Canada. Open Forum Infect Dis 2022; 9:ofac021. [PMID: 35174253 PMCID: PMC8843081 DOI: 10.1093/ofid/ofac021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/11/2022] [Indexed: 11/30/2022] Open
Abstract
Emergomyces canadensis pulmonary infection was incidentally diagnosed in an asymptomatic patient suspected to have metastatic osteosarcoma. Molecular diagnosis was imperative to fungal identification given overlapping histopathological features with histoplasmosis. This report documents a case of isolated pulmonary emergomycosis in an otherwise immunocompetent patient while discussing diagnostic and management pitfalls of this emerging and underdiagnosed infection.
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Affiliation(s)
- Jordan Mah
- Section of Infectious Diseases, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Andrea Bakker
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Calvin Tseng
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lucie Lafay-Cousin
- Section of Pediatric Hematology Oncology and Bone Marrow Transplantation, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Susan Kuhn
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Marie-Anne Brundler
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Luiz F Lisboa
- Section of Microbiology, Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Xiao YD, Lv FJ, Li WJ, Fu BJ, Lin RY, Chu ZG. Solitary Pulmonary Inflammatory Nodule: CT Features and Pathological Findings. J Inflamm Res 2021; 14:2741-2751. [PMID: 34211291 PMCID: PMC8242128 DOI: 10.2147/jir.s304431] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/26/2021] [Indexed: 12/19/2022] Open
Abstract
Purpose Solitary pulmonary inflammatory nodules (SPINs) are frequently misdiagnosed as malignancy. We aimed to investigate CT features and pathological findings of SPINs for improving diagnosis strategies. Patients and Methods In this retrospective study, 225 and 310 consecutive patients with confirmed SPINs and lung cancerous nodules were enrolled from January 2013 to December 2020. Nodules were classified into different types based on the key CT features: I, homogeneous and well-defined nodules with smooth (Ia), coarse (Ib), or spiculated margins (Ic); II, nodules with blurred boundaries, peripheral patches, or both; III, nodules exhibiting heterogeneous density; and IV, polygonal nodules. The pathological findings of SPINs were simultaneously studied and summarized. Results Among the 225 SPINs, type I (Ia, Ib, and Ic), II, III, and IV were 137 (60.9%) (47 [20.9%], 33 [14.7%], and 57 [25.3%]), 62 (27.6%), 12 (5.3%) and 14 (6.2%), respectively. Correspondingly, those in 310 cancerous nodules were 275 (88.7%) (119 [38.4%], 70 [22.6%], and 86 [27.7%]), 20 (6.5%), 15 (4.8%), and 0, respectively. Compared with lung cancers, type I nodules were less common but type II and IV nodules were more common in SPINs (each P < 0.0001). Though the frequencies of subtype I (P = 0.095) and type III (P = 0.796) nodules were similar between two groups, their specific CT features were significantly different. The main pathological findings of each type of SPINs were most extensively identical (82.2 - 100%). Conclusion Between cancerous nodules and SPINs, differences in overall or specific CT features exist. The type II and IV nodules are highly indicative of SPINs, and each type of SPINs have almost similar pathological findings.
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Affiliation(s)
- Yun-Dan Xiao
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Fa-Jin Lv
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Wang-Jia Li
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Bin-Jie Fu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Rui-Yu Lin
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Zhi-Gang Chu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
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Chen Y, He X, Shang J, Zhang N, Li X, Liu J, Xu L, Liu D, Li Y, Sun Z, Wen Z. CT Findings of Pulmonary Metastases from Primary Cardiac Angiosarcoma. Curr Med Imaging 2021; 17:1216-1220. [PMID: 34061006 DOI: 10.2174/1573405617666210521151753] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/01/2021] [Accepted: 02/17/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Primary cardiac angiosarcoma is a rare malignancy with high predilection to involve surrounding structures such as pulmonary metastases. We analysed the chest computed tomography (CT) imaging features of patients diagnosed with primary cardiac angiosarcoma with pulmonary metastases in this study. METHODS This study retrospectively reviewed 12 patients with confirmed primary cardiac angiosarcoma, out of which eight (all men) with pulmonary metastasis were included in the analysis. The patients' age ranged from 17 to 74 (mean: 48) years. CT was performed in all patients with unenhanced, contrast-enhanced, and both scans were done in 1, 3 and 4 patients, respectively. RESULTS Nodular lesions were observed in 7 patients with multiple solid nodules observed in 6 out of 7 patients. A solitary solid nodule was found in the remaining patient in the upper lobe and apical segment of the right lung with a diameter of 11.7 mm. All solid nodules were distributed along with bronchovascular bundles in the lungs, and their maximum diameter ranged from 2.3 to 19.9 mm. Nodules larger than 10 mm in diameter were heterogeneously enhanced on contrast-enhanced CT images (5/8 patients), whereas those smaller than 10 mm were homogeneously enhanced (3/8 patients). Other imaging features, namely the tree-in-bud pattern, emphysema, pleural effusion, and mediastinal lymph node enlargement, were observed in 4, 3, 3, and 2 patients, respectively. CONCLUSION CT enhancement features of pulmonary metastasis in patients with primary cardiac angiosarcoma depend on the size of pulmonary nodules, with larger ones being heterogeneous and smaller ones homogeneous. Other signs are less noticed.
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Affiliation(s)
- Yan Chen
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiang He
- Department of Diagnostic CT, Cangzhou Central Hospital, No. 16, Xinhua Road, Cangzhou 061001, Hebei, China
| | - Jianfeng Shang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Nan Zhang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiaodan Li
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jiayi Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Lei Xu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Dongting Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yu Li
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, Australia
| | - Zhaoying Wen
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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Caruso D, Polidori T, Guido G, Nicolai M, Bracci B, Cremona A, Zerunian M, Polici M, Pucciarelli F, Rucci C, Dominicis CD, Girolamo MD, Argento G, Sergi D, Laghi A. Typical and atypical COVID-19 computed tomography findings. World J Clin Cases 2020; 8:3177-3187. [PMID: 32874972 PMCID: PMC7441270 DOI: 10.12998/wjcc.v8.i15.3177] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/10/2020] [Accepted: 07/23/2020] [Indexed: 02/05/2023] Open
Abstract
In December 2019 a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 was identified and the disease associated was named coronavirus disease 2019 (COVID-19). Fever, cough, myalgia, fatigue associated to dyspnea represent most common clinical symptoms of the disease. The reference standard for diagnosis of severe acute respiratory syndrome coronavirus 2 infection is real time reverse-transcription polymerase chain reaction test applied on respiratory tract specimens. Despite of lower specificity, chest computed tomography (CT), as reported in manifold scientific studies, showed high sensitivity, therefore it may help in the early detection, management and follow-up of COVID-19 pneumonia. Patients affected by COVID-19 pneumonia usually showed on chest CT some typical features, such as: Bilateral ground glass opacities characterized by multilobe involvement with posterior and peripheral distribution; parenchymal consolidations with or without air bronchogram; interlobular septal thickening; crazy paving pattern, represented by interlobular and intralobular septal thickening surrounded by ground-glass opacities; subsegmental pulmonary vessels enlargement (> 3 mm). Halo sign, reversed halo sign, cavitation and pleural or pericardial effusion represent some of atypical findings of COVID-19 pneumonia. On the other hand lymphadenopathy's and bronchiectasis' frequency is unclear, indeed conflicting data emerged in literature. Radiologists play a key role in recognition of high suspicious findings of COVID-19 on chest CT, both typical and atypical ones. Thus, the aim of this review is to illustrate typical and atypical CT findings of COVID-19.
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Affiliation(s)
- Damiano Caruso
- Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza”-University of Rome, Sant'Andrea University Hospital, AOU Sant’Andrea, Rome 00189, Italy
| | - Tiziano Polidori
- Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza”-University of Rome, Sant'Andrea University Hospital, AOU Sant’Andrea, Rome 00189, Italy
| | - Gisella Guido
- Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza”-University of Rome, Sant'Andrea University Hospital, AOU Sant’Andrea, Rome 00189, Italy
| | - Matteo Nicolai
- Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza”-University of Rome, Sant'Andrea University Hospital, AOU Sant’Andrea, Rome 00189, Italy
| | - Benedetta Bracci
- Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza”-University of Rome, Sant'Andrea University Hospital, AOU Sant’Andrea, Rome 00189, Italy
| | - Antonio Cremona
- Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza”-University of Rome, Sant'Andrea University Hospital, AOU Sant’Andrea, Rome 00189, Italy
| | - Marta Zerunian
- Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza”-University of Rome, Sant'Andrea University Hospital, AOU Sant’Andrea, Rome 00189, Italy
| | - Michela Polici
- Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza”-University of Rome, Sant'Andrea University Hospital, AOU Sant’Andrea, Rome 00189, Italy
| | - Francesco Pucciarelli
- Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza”-University of Rome, Sant'Andrea University Hospital, AOU Sant’Andrea, Rome 00189, Italy
| | - Carlotta Rucci
- Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza”-University of Rome, Sant'Andrea University Hospital, AOU Sant’Andrea, Rome 00189, Italy
| | - Chiara De Dominicis
- Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza”-University of Rome, Sant'Andrea University Hospital, AOU Sant’Andrea, Rome 00189, Italy
| | - Marco Di Girolamo
- Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza”-University of Rome, Sant'Andrea University Hospital, AOU Sant’Andrea, Rome 00189, Italy
| | - Giuseppe Argento
- Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza”-University of Rome, Sant'Andrea University Hospital, AOU Sant’Andrea, Rome 00189, Italy
| | - Daniela Sergi
- Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza”-University of Rome, Sant'Andrea University Hospital, AOU Sant’Andrea, Rome 00189, Italy
| | - Andrea Laghi
- Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza”-University of Rome, Sant'Andrea University Hospital, AOU Sant’Andrea, Rome 00189, Italy
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Wang S, Zheng Y, Wang Z, Yao X, Dong B, Liu H, Qu J. Comparison of Chest CT Manifestations of Coronavirus Disease 2019 (COVID-19) and Pneumonia Associated with Lymphoma. Int J Med Sci 2020; 17:1909-1915. [PMID: 32788869 PMCID: PMC7415398 DOI: 10.7150/ijms.46688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 07/09/2020] [Indexed: 11/06/2022] Open
Abstract
Objective: To retrospectively compare the clinical features and chest computed tomography (CT) characteristics of coronavirus disease 2019 (COVID-19) and pneumonia in lymphoma patients. Materials and Methods: Ten lymphoma patients with pneumonia and 12 patients with COVID-19 infections were enrolled from January 15 to March 14, 2020. The clinical features were recorded. All pulmonary lesions on chest CT were assessed for location, shape, density and diffusion degree. Other typical CT features were also evaluated. Results: The most commonly observed patchy lesions were ground-glass opacities (GGOs) and mixed GGOs in both groups. Regarding the diffusion degree, 82% (92/112) of the lesions in the COVID-19 group were relatively limited, while 69% (52/75) of those in the lymphoma group were diffuse (p < 0.001). The proportions of interlobular septal thickening, vascular thickening, pleural involvement and fibrous stripes observed in the lymphoma cases were statistically compatible with those observed in the COVID-19 cases (p > 0.05). Air bronchograms were observed more frequently in COVID-19 patients (45%, 50/112) than in lymphoma patients with pneumonia (5%, 4/75) (p < 0.001). Halo sign (6%) and reversed halo sign (1%) were observed in several COVID-19 patients but not in lymphoma-associated pneumonia patients. Conclusion: Both lymphoma-associated pneumonia and COVID-19 generally manifested as patchy GGOs and mixed GGOs in more than one lobe. Compared to COVID-19, lymphoma-associated pneumonia tended to be relatively diffuse, with fewer air bronchograms, and no halo or reversed halo signs observed on chest CT.
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Affiliation(s)
- Shuting Wang
- Department of Radiology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, 127 Dongming Rd, Zhengzhou 450008, China
| | - Yinshi Zheng
- Department of Radiology, the First People's Hospital of Shangqiu, 292 South Kaixuan Rd, Shangqiu 476100, China
| | - Zhaoqi Wang
- Department of Radiology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, 127 Dongming Rd, Zhengzhou 450008, China
| | - Xiaoqiang Yao
- Department of Radiology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, 127 Dongming Rd, Zhengzhou 450008, China
| | - Bei Dong
- Department of Radiology, the First People's Hospital of Shangqiu, 292 South Kaixuan Rd, Shangqiu 476100, China
| | - Huan Liu
- GE Healthcare, Shanghai 201203, China
| | - Jinrong Qu
- Department of Radiology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, 127 Dongming Rd, Zhengzhou 450008, China
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