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エキスパートはこう考える第3回回答

投稿日:2011年4月30日作成者: イチロウ

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急性好酸球性肺炎、acute eosinophilic pneumonia, eosinophilic lung diseases、カーリーライン、Kerley line, Kerley B line、広義間質、bronchovascular bundle, septal line, 小葉間隔壁、non cardiogenic edema、薬剤性肺障害

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正常時

発症時

<参考文献＞

急性好酸球性肺炎文献集

Jeong YJ, Kim KI, Seo IJ, Lee CH, Lee KN, Kim KN, Kim JS, Kwon WJ.

Eosinophilic lung diseases: a clinical, radiologic, and pathologic overview.

Radiographics. 2007 May-Jun;27(3):617-37; discussion 637-9.

http://radiographics.rsna.org/content/27/3/617.full.pdf+html

AEP症例報告 Abe K, Yanagi S, Imadsu Y, Sano A, Iiboshi H, Mukae H, Matsukura S.

Acute eosinophilic pneumonia with fine nodular shadows.

Intern Med. 2003 Jan;42(1):88-91.

Shiota Y, Kawai T, Matsumoto H, Hiyama J, Tokuda Y, Marukawa M, Ono T, Mashiba H.

Acute eosinophilic pneumonia following cigarette smoking.

Intern Med. 2000 Oct;39(10):830-3.

症例報告の直截リンクは張れませんが、Freeで取れます。画像は決してよいと言えません。

画像はpoorだが、臨床的なこと知りたい場合

Philit F, Etienne-Mastroianni B, Parrot A, Guerin C, Robert D, Cordier JF.

Idiopathic acute eosinophilic pneumonia: a study of 22 patients.

Am J Respir Crit Care Med. 2002 Nov 1;166(9):1235-9.

http://ajrccm.atsjournals.org/cgi/reprint/166/9/1235

参考として薬剤性肺炎の論文

Rossi SE, Erasmus JJ, McAdams HP, Sporn TA, Goodman PC.

Pulmonary drug toxicity: radiologic and pathologic manifestations.

Radiographics. 2000 Sep-Oct;20(5):1245-59. Review.

http://radiographics.rsna.org/content/20/5/1245.full.pdf+html

エキスパートはこう考える第10回　回答

投稿日:2010年10月4日作成者: イチロウ

iphone movie

<key words>chronic eosinophilic pneumonia, reversed halo sign､Loeffler’s syndrome, 慢性好酸球性肺炎、レフレル症候群、BOOP,COP

<参考文献＞

Chronic eosinophilic pneumonia
Jeong YJ, Kim KI, Seo IJ, Lee CH, Lee KN, Kim KN, Kim JS, Kwon WJ.
Eosinophilic lung diseases: a clinical, radiologic, and pathologic overview.
Radiographics. 2007 May-Jun;27(3):617-37; discussion 637-9. Review.
http://radiographics.rsna.org/content/27/3/617.full.pdf+html

Kim SJ, Lee KS, Ryu YH, Yoon YC, Choe KO, Kim TS, Sung KJ.
Reversed halo sign on high-resolution CT of cryptogenic organizing pneumonia: diagnostic implications.
AJR Am J Roentgenol. 2003 May;180(5):1251-4.
http://www.ajronline.org/cgi/reprint/180/5/1251

Arakawa H, Kurihara Y, Niimi H, Nakajima Y, Johkoh T, Nakamura H.
Bronchiolitis obliterans with organizing pneumonia versus chronic eosinophilic pneumonia: high-resolution CT findings in 81 patients.
AJR Am J Roentgenol. 2001 Apr;176(4):1053-8.
http://www.ajronline.org/cgi/reprint/176/4/1053

Johkoh T, Muller NL, Akira M, et al.
Eosinophilic lung diseases: diagnostic accuracy of thin-section CT in 111 patients.
Radiology. 2000 Sep;216(3):773-80
http://radiology.rsna.org/content/216/3/773.full.pdf+html

Kim Y, Lee KS, Choi DC, Primack SL, Im JG.
The spectrum of eosinophilic lung disease: radiologic findings.
J Comput Assist Tomogr. 1997 Nov-Dec;21(6):920-30.

Ebara H, Ikezoe J, Johkoh T, Kohno N, Takeuchi N, Kozuka T, Ishida O.
Chronic eosinophilic pneumonia: evolution of chest radiograms and CT features.
J Comput Assist Tomogr. 1994 Sep-Oct;18(5):737-44.

Yoshida K, Shijubo N, Koba H, Mori Y, Satoh M, Morikawa T, Abe S.
Chronic eosinophilic pneumonia progressing to lung fibrosis.
Eur Respir J. 1994 Aug;7(8):1541-4.
http://erj.ersjournals.com/content/7/8/1541.long

Hayakawa H, Sato A, Toyoshima M, Imokawa S, Taniguchi M
A clinical study of idiopathic eosinophilic pneumonia.
Chest. 1994 May;105(5):1462-6.

Mayo JR, Muller NL, Road J, Sisler J, Lillington G.
Chronic eosinophilic pneumonia: CT findings in six cases.
AJR Am J Roentgenol. 1989 Oct;153(4):727-30.
http://www.ajronline.org/cgi/reprint/153/4/727

Reversed halo sign
Tzilas V, Bastas A, Provata A, Koti A, Tzouda V, Tsoukalas G.
The “reversed halo” sign in pneumonococcal pneumonia: a review with a case report.
Eur Rev Med Pharmacol Sci. 2010 May;14(5):481-6. Review.

Marchiori E, Zanetti G, Hochhegger B, Carvalho JF.
Sarcoid cluster sign and the reversed halo sign: Extending the spectrum of radiographic manifestations in sarcoidosis.
Eur J Radiol. 2010 May 18. [Epub ahead of print] No abstract available.

Marchiori E, Grando RD, Simoes Dos Santos CE, Maffazzioli Santos Balzan L, Zanetti G, Mano CM, Gutierrez RS.
Pulmonary tuberculosis associated with the reversed halo sign on high-resolution CT.
Br J Radiol. 2010 Mar;83(987):e58-60.

Benamore RE, Weisbrod GL, Hwang DM, Bailey DJ, Pierre AF, Lazar NM, Maimon N.
Reversed halo sign in lymphomatoid granulomatosis.
Br J Radiol. 2007 Aug;80(956):e162-6.
http://bjr.birjournals.org/cgi/reprint/80/956/e162

Arai T, Inoue Y, Ando S, Inoue K, Tsuyuguchi K, Suzuki K, Hayashi S, Kitaichi M, Akira M, Sakatani M.
[A case of cryptogenic organizing pneumonia showing reversed halo sign on computed tomography of the chest]
Nihon Kokyuki Gakkai Zasshi. 2007 Aug;45(8):621-6. Japanese.

Ueda S, Inoue R, Tanaka K, Mizumori Y, Kawamura T, Nakahara Y, Mochizuki Y, Kobashi Y.
[A case of nonspecific interstitial pneumonia with reversed halo sign on chest HRCT]
Nihon Kokyuki Gakkai Zasshi. 2007 Mar;45(3):248-52. Japanese.

Gasparetto EL, Escuissato DL, Davaus T, de Cerqueira EM, Souza AS Jr, Marchiori E, Muller NL.
Reversed halo sign in pulmonary paracoccidioidomycosis.
AJR Am J Roentgenol. 2005 Jun;184(6):1932-4.
http://www.ajronline.org/cgi/reprint/184/6/1932

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エキスパートはこう考える第8回　回答

投稿日:2010年7月28日作成者: イチロウ

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<キーワード＞RA, Rheumatoid arthritis, PCP, pneumocystis pneumonia, panlobular distribution, MTX, methotrexate, リウマチ、ニューモシスチス肺炎、氾小葉性分布，メトトレキセートによる薬剤性肺障害

＜参考文献＞

pneumocystis pneumonia with rheumatoid arthritis
Tasaka S, Tokuda H, Sakai F, et al.
Comparison of clinical and radiological features of pneumocystis pneumonia between malignancy cases and acquired immunodeficiency syndrome cases: a multicenter study.
Intern Med. 2010;49(4):273-81. Epub 2010 Feb 15.

Tokuda H, Sakai F, Yamada H, et al.
Clinical and radiological features of Pneumocystis pneumonia in patients with rheumatoid arthritis, in comparison with methotrexate pneumonitis and Pneumocystis pneumonia in acquired immunodeficiency syndrome
Intern Med. 2008;47(10):915-23. Epub 2008 May 15.

Minagawa S, Takayanagi N, Hara K, et al.
A case of rheumatoid arthritis complicated with methotrexate-induced pneumonitis and pneumocystis pneumonia
Nihon Kokyuki Gakkai Zasshi. 2008 Mar;46(3):237-42.

Mori S, Cho I, Ichiyasu H, et al.
Asymptomatic carriage of Pneumocystis jiroveci in elderly patients with rheumatoid arthritis in Japan: a possible association between colonization and development of Pneumocystis jiroveci pneumonia during low-dose MTX therapy.
Mod Rheumatol. 2008;18(3):240-6. Epub 2008 Feb 29.

Kaneko Y, Suwa A, Ikeda Y, et al.
Pneumocystis jiroveci pneumonia associated with low-dose methotrexate treatment for rheumatoid arthritis: report of two cases and review of the literature.
Mod Rheumatol. 2006;16(1):36-8.

pneumocystis pneumonia
Bergin CJ, Wirth RL, Berry GJ, et al.
Pneumocystis carinii pneumonia: CT and HRCT observations.
J Comput Assist Tomog. 1990 Sep-Oct;14(5):756-9.

Kuhlman JE, Kavuru M, Fishman EK, et al.
Pneumocystis carinii pneumonia: spectrum of parenchymal CT findings.
Radiology. 1990 Jun;175(3):711-4.

Feurestein IM, Archer A, Pluda JM, et al.
Thin-walled cavities, cysts, and pneumothorax in Pneumocystis carinii pneumonia: further observations with histopathologic correlation.
Radiology. 1990 Mar;174(3 Pt 1):697-702.

Hidalgo A, Falco V, Mauleon S, et al.
Accuracy of high-resolution CT in distinguishing between Pneumocystis carinii pneumonia and non- Pneumocystis carinii pneumonia in AIDS patients.
Eur Radiol. 2003 May;13(5):1179-84. Epub 2002 Sep 25.

Boiselle PM, Crans CA Jr, Kaplan MA
The changing face of Pneumocystis carinii pneumonia in AIDS patients.
AJR Am J Roentgenol. 1999 May;172(5):1301-9.

Gruden JF, Huang L, Turner J, et al.
High-resolution CT in the evaluation of clinically suspected Pneumocystis carinii pneumonia in AIDS patients with normal, equivocal, or nonspecific radiographic findings.
AJR Am J Roentgenol. 1997 Oct;169(4):967-75.

Tsukada H, Yoshimura N, Yamamoto T, et al.
[High-resolution CT findings of Pneumocystis carinii pneumonia]
Nippon Igaku Hoshasen Gakkai Zassh. 1995 May;55(6):369-74.

Hartman TE, Primack SL, Muller NL, et al.
Diagnosis of thoracic complications in AIDS: accuracy of CT.
AJR Am J Roentgenol. 1994 Mar;162(3):547-53.

Moskovic E, Miller R, Pearson M.
High resolution computed tomography of Pneumocystis carinii pneumonia in AIDS.
Clin Radiol. 1990 Oct;42(4):239-43.

crazy-paving pattern
Rossi SE, Erasmus JJ, Volpacchio M, et al.
“Crazy-paving” pattern at thin-section CT of the lungs: radiologic-pathologic overview.
Radiographics. 2003 Nov-Dec;23(6):1509-19.

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胸部単純写真全体像	右肩関節
左肩関節	左肩関節フォーカス
CT1	CT2
CT3	CT4

エキスパートはこう考える第7回　回答

投稿日:2010年7月5日作成者: イチロウ

iphone movie

<Key words>ブラ壁肥厚、菌球、fungus ball、アスペルギルス症、アスペルギローマ、aspergilloma, invasive aspergillosis, semi-invasive aspergillosis, ABPA, 宿主や局所の免疫状態

<論文>

日本語のまとまった肺真菌症のPDF
国立病院機構東京病院臨床研究部長倉島篤行のPDFより引用リンク
http://medical.radionikkei.jp/abbott/final/pdf/051125.pdf

Agarwal R, Gupta D, Aggarwal AN, et al.
Clinical significance of hyperattenuating mucoid impaction in allergic bronchopulmonary aspergillosis: an analysis of 155 patients.
Chest. 2007 Oct;132(4):1183-90. Epub 2007 Jul 23.
http://chestjournal.chestpubs.org/content/132/4/1183.full.pdf+html

Jeong YJ, Kim KI, Seo IJ, et al.
Eosinophilic lung diseases: a clinical, radiologic, and pathologic overview.
Radiographics. 2007 May-Jun;27(3):617-37; discussion 637-9.

Kobashi Y, Fukuda M, Yoshida K, Miyashita N, Niki Y, Oka M.
Chronic necrotizing pulmonary aspergillosis as a complication of pulmonary Mycobacterium avium complex disease.
Respirology. 2006 Nov;11(6):809-13.

Althoff Souza C, Muller NL, Marchiori E, et al.
Pulmonary invasive aspergillosis and candidiasis in immunocompromised patients: a comparative study of the high-resolution CT findings.
J Thorac Imaging. 2006 Aug;21(3):184-9.

Agarwal R, Gupta D, Aggarwal AN, et al.
Allergic bronchopulmonary aspergillosis: lessons from 126 patients attending a chest clinic in north India.
Chest. 2006 Aug;130(2):442-8.
http://chestjournal.chestpubs.org/content/130/2/442.full.pdf+html

Brodoefel H, Vogel M, Hebart H, et al.
Long-term CT follow-up in 40 non-HIV immunocompromised patients with invasive pulmonary aspergillosis: kinetics of CT morphology and correlation with clinical findings and outcome.
AJR Am J Roentgenol. 2006 Aug;187(2):404-13.
http://www.ajronline.org/cgi/reprint/187/2/404

Horger M, Hebart H, Einsele H, et al.
Initial CT manifestations of invasive pulmonary aspergillosis in 45 non-HIV immunocompromised patients: association with patient outcome?
Eur J Radiol. 2005 Sep;55(3):437-44. Epub 2005 Jan 28

Lee YR, Choi YW, Lee KJ, et al.
CT halo sign: the spectrum of pulmonary diseases.
Br J Radiol. 2005 Sep;78(933):862-5. Review.
http://bjr.birjournals.org/cgi/reprint/78/933/862

Horger M, Einsele H, Schumacher U, Wehrmann M, Hebart H, Lengerke C, Vonthein R, Claussen CD, Pfannenberg C.
Invasive pulmonary aspergillosis: frequency and meaning of the “hypodense sign” on unenhanced CT.
Br J Radiol. 2005 Aug;78(932):697-703.
http://bjr.birjournals.org/cgi/reprint/78/932/697

Sonnet S, Buitrago-Tellez CH, Tamm M, et al.
Direct detection of angioinvasive pulmonary aspergillosis in immunosuppressed patients: preliminary results with high-resolution 16-MDCT angiography.
AJR Am J Roentgenol. 2005 Mar;184(3):746-51.
http://www.ajronline.org/cgi/reprint/184/3/746

Andreu J, Caceres J, Pallisa E, et al.
Radiological manifestations of pulmonary tuberculosis.
Eur J Radiol. 2004 Aug;51(2):139-49.

Franquet T, Gimenez A, Hidalgo A.
Imaging of opportunistic fungal infections in immunocompromised patient.
Eur J Radiol. 2004 Aug;51(2):130-8.

Buckingham SJ, Hansell DM
Aspergillus in the lung: diverse and coincident forms.
Eur Radiol. 2003 Aug;13(8):1786-800. Epub 2003 May 29.

Kang EY, Kim DH, Woo OH, et al.
Pulmonary aspergillosis in immunocompetent hosts without underlying lesions of the lung: radiologic and pathologic findings.
AJR Am J Roentgenol. 2002 Jun;178(6):1395-9.
http://www.ajronline.org/cgi/reprint/178/6/1395

Franquet T, Serrano F, Gimenez A, et al.
Necrotizing aspergillosis of large airways: CT findings in eight patients.
J Comput Assist Tomogr. 2002 May-Jun;26(3):342-5.

Kato T, Usami I, Morita H, et al.
Chronic necrotizing pulmonary aspergillosis in pneumoconiosis: clinical and radiologic findings in 10 patients.
Chest. 2002 Jan;121(1):118-27.
http://chestjournal.chestpubs.org/content/121/1/118.full.pdf+html

Soubani AO, Chandrasekar PH
The clinical spectrum of pulmonary aspergillosis.
Chest. 2002 Jun;121(6):1988-99.
http://chestjournal.chestpubs.org/content/121/6/1988.full.pdf+html

Franquet T, Muller NL, Gimenez A, et al.
Spectrum of pulmonary aspergillosis: histologic, clinical, and radiologic findings.
Radiographics. 2001 Jul-Aug;21(4):825-37. Review.
http://radiographics.rsna.org/content/21/4/825.full.pdf+html

Kim MJ, Lee KS, Kim J, et al.
Crescent sign in invasive pulmonary aspergillosis: frequency and related CT and clinical factors.
J Comput Assist Tomogr. 2001 Mar-Apr;25(2):305-10.

Aquino SL, Kee ST, Warnock ML, et al.
Pulmonary aspergillosis: imaging findings with pathologic correlation.
AJR Am J Roentgenol. 1994 Oct;163(4):811-5.
http://www.ajronline.org/cgi/reprint/163/4/811

Greene R
The pulmonary aspergilloses: three distinct entities or a spectrum of disease.
Radiology 1981 Aug;140(2):527-30.

Klein DL, Gamus G
Thoracic manifestations of aspergillosis.
AJR Am J Roentgneol. 1980 Mar;134(3):543-52.
http://www.ajronline.org/cgi/reprint/134/3/543
単純写真のみをまとめたレビュー論文

内科系論文
Bulpa P, Dive A, Sibille Y.
Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease.
Eur Respir J. 2007 Oct;30(4):782-800.
http://erj.ersjournals.com/cgi/reprint/30/4/782

Muquim A, Dial S, Menzies D.
Invasive aspergillosis in patients with chronic obstructive pulmonary diseases.
Can Respir J. 2005 May-Jun;12(4):199-204.
http://www.ncbi.nlm.nih.gov/sites/pubmed　　右上のFull text article pulsus をクリックした後、さらに　PDF/Free をクリックするとPDFが入手可能

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1 年前の胸部単純写真	1 年前の胸部 CT
今回の胸部単純写真初回	今回の胸部単純写真左上肺野拡大
今回の胸部単純写真左下肺野	今回の CT1
今回の CT2	今回の CT 冠状断
今回の CT 矢状断