Radiographic Findings--5/29/00

Frontal radiograph shows extensive peripheral pulmonary densities, which are somewhat ill-defined with some band-like and wedge shapes. The perihilar vessels are also somewhat ill-defined, suggesting an additional central component to this process.

 

 

Lateral radiograph confirms the peripheral and perihilar ill-defined densities. Also evident, in retrospect, is an approximately 1.5 cm pulmonary nodule seen just above the posterior right diaphragm (see gross findings).

CT Findings

In 6 patients with dermatomyositis and lung disease, CT changes predominated in the lower lung fields bilaterally. The characteristic changes are summarized below [1].

A

 

Match the descriptions with the appropriate letters on the CTs from our patient (figures A, B, C).

  • Pleural irregularities, which indicate involvement of subpleural interstitium by inflammation or fibrosis___
  • Prominent interlobular septa___
  • Patchy ground-glass attenuation or consolidation___
  • Parenchymal bands: thick lines parallel to the chest wall in the subpleural region___
  • Irregular peribronchovascular thickening___

Answers

 

 

B

C

The T in figure C, in retrospect, represents tumor.

Distribution of individual lesions and course in the 6 patients: The first three features tend to be distributed uniformly in the upper, mid, and lower lung zones; the last two predominate in the mid and lower lung zones.

Follow-up showed decreases in consolidation, parenchymal bands, and irregular peribronchovascular thickening in the 5 patients who improved [1].

Reference:

1. Mino M, Noma S, Taguchi Y, Tomii K, Kohri Y, Oida K. Pulmonary involvement in polymyositis and dermatomyositis: sequential evaluation with CT. AJR 1997; 169:83-87.

Clinical summary Image 1

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Answers

In 6 patients with DM and lung disease, CT changes predominated in the lower long fields bilaterally. Changes are summarized below [1].

Match the descriptions with the appropriate letters on the CTs.

  • Pleural irregularities, which indicate involvement of subpleural interstitium by inflammation or fibrosis D
  • Prominent interlobular septa C
  • Patchy ground-glass attenuation or consolidation E
  • Parenchymal bands: thick lines parallel to the chest wall in the subpleural region A
  • Irregular peribronchovascular thickening B

 

 

Clinical summary Image 1

Table of Contents