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von Ranke F. High-resolution computed tomography findings in hantavirus pulmonary syndrome. Radiol Bras 2017; 50:VII-VIII. [PMID: 28894346 PMCID: PMC5586527 DOI: 10.1590/0100-3984.2017.50.4e2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Felipe von Ranke
- Assistant Professor of Radiology at the Universidade Federal Fluminense (UFF), Niterói, RJ, Radiologist and Medical Coordinator at Dimagem - Diagnóstico por Imagem, Nova Iguaçu, RJ, Brazil. E-mail:
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Barbosa DDL, Hochhegger B, Souza AS, Zanetti G, Escuissato DL, Meirelles GDSP, Funari MBDG, Marchiori E. High-resolution computed tomography findings in eight patients with hantavirus pulmonary syndrome. Radiol Bras 2017; 50:148-153. [PMID: 28670025 PMCID: PMC5487228 DOI: 10.1590/0100-3984.2016.0093] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective: The purpose of this study was to describe the high-resolution computed
tomography (HRCT) findings in patients with hantavirus pulmonary syndrome
(HPS). Materials and Methods: We retrospectively reviewed HRCT findings from eight cases of HPS. All
patients were men, aged 19-70 (mean, 41.7) years. Diagnoses were established
by serological test (enzyme-linked immunosorbent assay) in all patients. Two
chest radiologists analyzed the images and reached decisions by
consensus. Results: The predominant HRCT findings were ground-glass opacities (GGOs) and smooth
inter- and intralobular septal thickening, found in all eight cases;
however, the crazy-paving pattern was found in only three cases. Pleural
effusion and peribronchovascular thickening were observed in five patients.
The abnormalities were bilateral in all patients. Conclusion: The predominant HRCT findings in patients with HPS were GGOs and smooth
inter- and intralobular septal thickening, which probably correlate with the
histopathologic findings of pulmonary edema.
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Affiliation(s)
| | | | - Arthur Soares Souza
- MD, PhD, Faculdade de Medicina de São José do Rio Preto (Famerp) and Ultra X, São José do Rio Preto, SP, Brazil
| | - Gláucia Zanetti
- MD, PhD, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | | | | | | | - Edson Marchiori
- MD, PhD, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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Feng Y, Zhao J, Yang Q, Xiong W, Zhen G, Xu Y, Zhang Z, Zhang H. Pulmonary melanoma and "crazy paving" patterns in chest images: a case report and literature review. BMC Cancer 2016; 16:592. [PMID: 27488496 PMCID: PMC4973081 DOI: 10.1186/s12885-016-2630-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 07/26/2016] [Indexed: 12/19/2022] Open
Abstract
Background In the lung, melanoma is mostly arranged as patterns of multiple nodules, solitary nodules, or miliary invasions. Very rarely, it also displays a “crazy paving” pattern (also described as a “paving stone,” “flagstone,” or “slabstone” pattern), which is rarer still in discrete bilateral nodules. This pattern is considered to be caused by pulmonary alveolar proteinosis, but its association with various diseases is unclear. Case presentation A 60-year-old man was diagnosed with pulmonary melanoma. Computed tomography revealed discrete bilateral nodules surrounded by a “paving” pattern. A literature review found more than 40 types of diseases that have presented with “paving” patterns in the lung—predominantly pulmonary alveolar proteinosis, viral pneumonia, exogenous lipoid pneumonia, bacterial pneumonia, pulmonary alveolar microlithiasis, interstitial pneumonia, ARDS, squalene aspiration pneumonia, radiation pneumonitis, drug-induced pneumonitis, pulmonary leptospirosis, pulmonary hemorrhage, and pulmonary nocardiosis. Conclusions We describe the first case of pulmonary melanoma in the form of discrete bilateral nodules accompanied with a computed tomography paving pattern. Although pulmonary paving patterns are rare, more than 40 diseases reportedly display them; clinicians should consider melanoma of the lung in differential diagnoses for patients who show such a pattern.
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Affiliation(s)
- Yikuan Feng
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jianping Zhao
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qun Yang
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Weining Xiong
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Guohua Zhen
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yongjian Xu
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zhenxiang Zhang
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Huilan Zhang
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Scordino D, Regan L. Crazy paving on computed tomography after marijuana use. J Emerg Med 2014; 46:e127-9. [PMID: 24462029 DOI: 10.1016/j.jemermed.2013.09.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 09/23/2013] [Accepted: 09/29/2013] [Indexed: 11/17/2022]
Affiliation(s)
- David Scordino
- Department of Emergency Medicine, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Linda Regan
- Department of Emergency Medicine, The Johns Hopkins Hospital, Baltimore, Maryland
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Paakkala A, Järvenpää R, Mäkelä S, Huhtala H, Mustonen J. Pulmonary high-resolution computed tomography findings in nephropathia epidemica. Eur J Radiol 2012; 81:1707-11. [PMID: 21600717 PMCID: PMC7125555 DOI: 10.1016/j.ejrad.2011.04.049] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2011] [Accepted: 04/21/2011] [Indexed: 02/08/2023]
Abstract
PURPOSE To evaluate lung high-resolution computed tomography (HRCT) findings in patients with Puumala hantavirus-induced nephropathia epidemica (NE), and to determine if these findings correspond to chest radiograph findings. MATERIALS AND METHODS HRCT findings and clinical course were studied in 13 hospital-treated NE patients. Chest radiograph findings were studied in 12 of them. RESULTS Twelve patients (92%) showed lung parenchymal abnormalities in HRCT, while only 8 had changes in their chest radiography. Atelectasis, pleural effusion, intralobular and interlobular septal thickening were the most common HRCT findings. Ground-glass opacification (GGO) was seen in 4 and hilar and mediastinal lymphadenopathy in 3 patients. Atelectasis and pleural effusion were also mostly seen in chest radiographs, other findings only in HRCT. CONCLUSION Almost every NE patient showed lung parenchymal abnormalities in HRCT. The most common findings of lung involvement in NE can be defined as accumulation of pleural fluid and atelectasis and intralobular and interlobular septal thickening, most profusely in the lower parts of the lung. As a novel finding, lymphadenopathy was seen in a minority, probably related to capillary leakage and overall fluid overload. Pleural effusion is not the prominent feature in other viral pneumonias, whereas intralobular and interlobular septal thickening are characteristic of other viral pulmonary infections as well. Lung parenchymal findings in HRCT can thus be taken not to be disease-specific in NE and HRCT is useful only for scientific purposes.
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Affiliation(s)
- Antti Paakkala
- Medical Imaging Centre, Tampere University Hospital, 33521 Tampere, Finland.
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Goeijenbier M, Wagenaar J, Goris M, Martina B, Henttonen H, Vaheri A, Reusken C, Hartskeerl R, Osterhaus A, Van Gorp E. Rodent-borne hemorrhagic fevers: under-recognized, widely spread and preventable – epidemiology, diagnostics and treatment. Crit Rev Microbiol 2012; 39:26-42. [DOI: 10.3109/1040841x.2012.686481] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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