周围型肺癌与支气管关系的HRCT研究

目的：探讨支气管薄层高分辨率CT(HRCT)扫描的表现对周围型肺癌的诊断和鉴别诊断价值。方法：回顾性分了经临床手术病理证实的37例周围型肺癌与23例其它孤立性良性病变的支气管HRCT表现及其相关因素。结果：周围型肺癌的支气管HRCT表现有一定特征性，与病灶的良恶性程度及病灶大小有关，而与病灶部位无关。结论：孤立性病灶周围支气管HRCT表现，对周围型肺癌的诊断与鉴别诊断有一定帮助。     

Idiopathic pulmonary fibrosis: spectrum of high-resolution CT findings

OBJECTIVE: Characteristic high-resolution CT (HRCT) findings of idiopathic pulmonary fibrosis (IPF) include reticulation, architectural distortion, and honeycombing involving mainly the lung periphery and the lower lobes. In 50% of IPF patients, HRCT is nonspecific. This article illustrates the HRCT findings of IPF correlating with the pathology. CONCLUSION: The spectrum of HRCT manifestations varies from typical findings that allow confident diagnosis to atypical patterns mimicking other diseases, including predominance of ground-glass opacity, consolidation, nodules, and atypical distribution of lesions.     

MSCT在结节或肿块型肺结核中的诊断价值

目的通过对比结节或肿块型不典型肺结核与周围型肺癌的MSCT表现,旨在提高结节或肿块型不典型肺结核诊断及鉴别诊断能力。方法收集我院2015年1月~2018年12月不典型肺结核103例,同期周围型肺癌患者96例,对比分析两组MSCT平扫及强化结果。结果深分叶征、短毛刺征、胸膜凹陷征、血管集束征、空洞内壁不光整、轻-中度或明显强化在周围型肺癌中出现率高,差异有统计学意义(P<0.05)。浅分叶征、长毛刺征、卫星灶、钙化、轻度及环形强化在结节或肿块型肺结核中出现率高,差异有统计学意义(P<0.05)。结论浅分叶征、长毛刺征、卫星灶、钙化、轻度及环形强化是结节或肿块型肺结核较特征性MSCT表现,征象出现越多,越提示结节或肿块型肺结核。     

周围型非小细胞肺癌CT边缘征与VEGF基因表达水平的相关性研究

目的 探讨周围型非小细胞肺(NSCLC)癌的血管内皮生长因子(VEGF)基因表达水平与其边缘征的关系.资料与方法 采用高分辨CT观察47例经病理证实的周围型NSCLC边缘征,同时运用免疫组织化学法LSAB法测定癌组织标本的VEGF基因表达水平,并对其相关性作统计学分析.结果 周围型NSCLC的深分叶征和棘突征与VEGF基因表达水平有关.结论 具有深分叶征和棘突征的周围型NSCLC恶性程度较高.     

Pulmonary tuberculosis presenting as acute respiratory failure: radiologic findings

PURPOSE: The purpose of this work was to describe the radiologic findings of pulmonary tuberculosis in patients who presented with acute respiratory failure. METHODS: We included patients who had newly diagnosed active pulmonary tuberculosis and who presented with acute respiratory failure. Initial chest radiographic (n = 17) and high-resolution CT (n = 11) findings of each patient were analyzed retrospectively. RESULTS: Of 1,010 patients with active pulmonary tuberculosis, 17 patients (1.7%) presented with acute respiratory failure. Nine (53%) of the 17 patients died. The most common initial chest radiographic findings were small nodular lesions (16/17; 94%), consolidation (13/17; 76%), and ground-glass opacity (12/17; 70%). Eleven (69%) of 16 nodular lesions, 9 of 13 (69%) consolidations, and 10 of 12 (83%) ground-glass opacities were bilateral. On HRCT (n = 11), miliary micronodular lesions were seen in 6 patients (55%), whereas bronchogenic spread of tuberculosis with disseminated centrilobular nodules and tree-in-bud appearance was seen in 5 patients (45%). Diffuse areas of ground-glass attenuation were seen in all six patients with miliary nodules and four of five patients with bronchogenic spread of tuberculosis. CONCLUSION: Patients with pulmonary tuberculosis occasionally present with acute respiratory failure. In this condition, chest radiograph most commonly shows bilateral small nodular lesions mixed with consolidation or ground-glass opacity, whereas HRCT demonstrates findings of miliary or bronchogenic disseminated tuberculosis with diffuse areas of ground-glass attenuation.     

新型冠状病毒肺炎首次胸部高分辨率CT影像分析

目的 探讨新型冠状病毒肺炎(COVID-19)首次胸部高分辨率CT(HRCT)影像表现。方法 回顾性分析2020年1月3日至25日武汉市中西医结合医院确诊的106例COVID-19患者的首次胸部HRCT图像,对病灶分布、形态及周围受累情况进行统计和分析。结果 106例COVID-19患者首次肺部HRCT均发现病灶,单侧肺分布11例(10.4%),双侧肺分布95例(89.6%);肺外周分布65例(61.3%),肺外周及中心同时分布41例(38.7%);1个病灶8例(7.5%),2个病灶5例(4.7%),多发病灶93例(87.8%);结节状病灶12例(11.3%),磨玻璃状病灶94例(88.7%),条索状病灶7例(6.6%),2种及以上形态共存病灶15例(14.2%);累及一个肺叶10例(9.4%),累及2个及以上肺叶96例(90.6%);纵隔淋巴结增大24例(22.6%)(>60岁患者19例,占79.2%),胸腔积液3例(2.8%),心包积液1例(0.9%),胸膜受累/增厚2例(1.9%)。>60岁患者多表现为多病灶,多形态,肺外周及中心同时分布,累及多个肺叶,纵隔淋巴结增大。结论 COVID-19患者首次胸部HRCT检查能发现肺部病灶,是首选的影像学检查方法,胸部HRCT扫描检查在NCP的早期诊断中有重要作用。     

Pulmonary lesions detected in population-based CT screening for lung cancer: reliable findings of benign lesions

PURPOSE: To identify the characteristics of benign pulmonary lesions in order to reduce false-positive rates in screening computed tomography (CT) and in order to reduce frequency of follow-up high-resolution CT (HRCT). MATERIALS AND METHODS: We evaluated 238 screening-detected benign lesions and 23 screening-detected lung cancers for 12 characteristics: spiculation, well-defined margin, concave margin, polygonal shape, notch/lobulation, solid component, ground-glass opacity (GGO), air bronchogram, cavity, bubble-like appearance, pleural indentation, and vascular convergence. We also measured the lesion diameters to set a threshold for benign lesions. We tested combinations of these characteristics to differentiate benign lesions from lung cancers. RESULTS: By using certain combinations of the characteristics that showed statistically significant differences between benign lesions and lung cancers, benign lesions could be extracted without contamination by lung cancer in screening CT, when the combination included solid component as a positive finding. In HRCT, more than 80% of the benign lesions could be extracted without contamination by lung cancer when the combination included GGO as a negative finding. CONCLUSION: It seems possible to reduce the frequency of follow-up HRCT to establish a diagnosis of benign lesions using certain combinations of the characteristics of benign nodules.     

Progressive worsening of idiopathic pulmonary fibrosis. High resolution computed tomography (HRCT) study with functional correlations

PURPOSE: To evaluate the usefulness of the high-resolution computed tomography (HRCT) visual score in idiopathic pulmonary fibrosis (IPF) and its correlation with respiratory function tests. MATERIAL AND METHODS: We studied the pulmonary function tests and HRCT scans of 42 IPF patients, at presentation (T0) and follow-up (T1: mean 13.7 months post-diagnosis). Of the 42 patients, 21 had been treated with steroid and immunosuppresion therapy. The pulmonary function tests considered were vital capacity (VC), diffusion lung capacity for carbon monoxide (D(L)CO) and arterial blood oxygen partial pressure (PaO(2)). The main HRCT parameters were type of lesion, and site and extent, the latter calculated by means of the visual score. RESULTS: Between T0 and T1, both mean HRCT score (from 43.57% to 50.64%) and lung function tests worsened (VC from 68.43% to 64.18%; D(L)CO from 36.31% to 28.97%; PaO(2) from 76.31 to 68.89 mmHg), without considerable differences between treated and untreated patients. At presentation (T0), the HRCT visual score had a significant correlation with lung function tests and these correlated with one another. Similar correlations were found at T1, but not for HRCT score and D(L)CO. In the interval between T0 and T1 the variations correlated significantly with each other, with two exceptions: HRCT score and D(L)CO, and D(L)CO and PaO(2). DISCUSSION AND CONCLUSIONS: IPF exhibited a progressive deterioration both in HRCT extent of disease and lung function impairment. There is a significant correlation between HRCT visual score and lung function tests both at diagnosis and at follow-up. The HRCT study is able to identify and quantify anatomic IPF and also to evaluate the progression of the disease. In clinical practice, the HRCT visual score of disease extent can be used in association with function tests to monitor IPF evolution, and to evaluate prognosis and therapy. In the future, helical CT with 3D model construction will provide a more precise IPF quantification with automatic score.     

Diffuse panbronchiolitis: correlation of high-resolution CT and pathologic findings.

Diffuse panbronchiolitis (DPB) is characterized by chronic airflow limitation and airway inflammation with bronchiolar lesions. Chest radiographs of patients with DPB usually show small nodular shadows throughout both lungs. The authors investigated the nature and pathogenesis of the radiologic features of DPB by correlating high-resolution computed tomographic (HRCT) findings with histopathologic features. The HRCT images of nine patients with DPB were compared with the observations made with inflated lung specimens. The HRCT findings of DPB included centrilobularly distributed, small rounded areas of attenuation; branched linear areas of attenuation, contiguous with the small rounded areas; dilated airways with thick walls, also common outside secondary pulmonary lobules; and decreased lung attenuation in peripheral areas due to air trapping caused by bronchiolar narrowing in the subpleural zones. The authors believe that HRCT best demonstrates this characteristic location of small rounded areas of attenuation associated with dilated airways.     

Serial HRCT lung changes after 3-field radiation treatment of breast cancer

AIMS: To document serial high resolution computed tomography (HRCT) features of lung injury after 3-field radiotherapy for breast cancer. MATERIALS AND METHODS: Thirty women who received opposing tangential chest wall and supraclavicular field (SCF) irradiation after breast surgery were recruited. Thoracic HRCT was performed before and at 1, 3, 6 and 12 months after radiotherapy (RT). Lung injury at 3 months was quantified by applying a scoring system to each HRCT section. Findings were correlated with spirometric lung function tests. RESULTS: There was HRCT evidence of lung injury in 27 (90%) women at 1 month and in all 30 patients at 3 months. Spirometric lung function declined post-RT (P < 0.05), correlating with an increased SCF acute lung injury score at 3 months [r = -0.54 and -0.46, P = 0.01 and 0.03 for forced expiratory volume in 1st (FEV(1)) and forced vital capacity (FVC), respectively]. Lung injury on HRCT progressed from ground glass opacification at 1 month to nodular consolidation (3 months), increasing linear densities (6 months), and finally to residual subpleural linear and dense opacities (12 months). CONCLUSION: There is a high incidence of lung injury associated with 3-field radiotherapy for breast cancer, with concurrent SCF irradiation increasing the risk of lung damage and functional impairment. A characteristic sequence of HRCT changes is seen in most patients receiving this type of radiotherapy.Ooi, G. C. (2000). Clinical Radiology55, 817-824.     

结节型局灶性机化性肺炎的CT表现

目的:分析结节型局灶性机化性肺炎的CT表现,探讨与周围型小肺癌的鉴别诊断。材料和方法:回顾性分析经手术病理证实的12例表现为孤立性肺结节的局灶性机化性肺炎的CT表现。结果:10例病灶邻近胸膜,其中8例合并相邻胸膜增厚粘连,6例位于各胸膜交界区。病灶边缘光整3例,毛糙9例,边缘有粗长毛刺征2例,细短毛刺征5例,分叶征3例,血管纠集征4例,棘状突起征2例;7例病灶内密度均匀,支气管空气征2例,空泡征1例,病灶内液化2例;强化明显6例,病灶明显强化率为54.5%;病灶周缘肺内渗出灶3例,卫星灶1例;病灶同侧少量胸腔积液3例。结论:NFOP的CT表现上除与胸膜关系密切外,其他表现常与SPLC相似,在长期密切随访观察病灶变化的基础上,行经皮肺穿刺活检以及创伤较小的电视胸腔镜下目标肺楔形切除是有必要的。     

Chronic hypersensitivity pneumonitis or idiopathic pulmonary fibrosis? Diagnostic role of high resolution Computed Tomography (HRCT)

PURPOSE: In the diagnosis of extrinsic allergic alveolitis, high-resolution computed tomography (HRCT) is more sensitive and more specific than radiography; however, the accuracy of HRCT is not absolute. The role of HRCT in this field has scarcely been investigated in the literature. The purpose of this paper is to explore the possibilities of HRCT in this field and to analyse the correlations between HRCT and functional parameters. MATERIALS AND METHODS: We performed a retrospective blind evaluation the HRCT scans of 24 patients (19 males and 5 females). Twelve were affected by idiopathic pulmonary fibrosis (IPF); 12 had chronic extrinsic allergic alveolitis (EAA) or hypersensitivity pneumonitis. The HRCT findings were studied by two radiologists, who were not aware of the diagnoses. The possible differences in evaluation were subsequently resolved by consensus. In the presence of interstitial fibrosis, we recorded the prevailing site and the anatomical extension (with the method of the visual percentage score, described in the literature). In all the cases, we recorded the blood gas values (PaO2, PaCO2, and pH), total lung capacity (TLC), forced expiratory volume in 1 second (FEV1), Vital Capacity (VC), Tiffeneau index (FEV1/VC) and monoxide carbon diffusion (DLCO). The statistical significance of the correlations was investigated using the Mann-Whitney and Wilcoxon tests. Student "t"-test and Pearson's chi squared were used to compare the variables of the different groups. A value of p< or =0.05 was considered significant. RESULTS: Overall, the diagnosis was formulated with a high degree of confidence in 13 of 24 cases (54.1%); in these patients, the result was correct in 84.6% of cases (11 of 13). In the diagnosis of EAA, HRCT sensitivity was 50%, with 91.6% specificity, 70.8% accuracy. In the diagnosis of IPF, HRCT sensitivity was 75%, with 83.3% specificity, 79.1% accuracy. The HRCT signs of interstitial fibrosis were visible in 11 cases of IPF (91.6%) and in 4 cases of EAA (33.3%), with significant statistical difference (p<0.005). In the analysis of the whole series (24 patients) we found a significant inverse correlation between the HRCT score of fibrosis and the extension of the areas with air-trapping (p<0.003). There was no significant difference between IPF and EAA considering age, FEV1, PaO2, PaCO2 and pH. We found inverse correlation (p<0.001) between HRCT extension of the fibrosis and DLCO. There was a significant difference between pulmonary fibrosis and extrinsic allergic alveolitis considering TLC (in average, respectively: 65% and 84.3%; p<0.02), and DLCO (respectively 40.4% and 74.7%; p<0.03). DISCUSSION AND CONCLUSIONS: HRCT is a reliable and strong method to be used in particularly complex fields. We found signs of interstitial fibrosis more frequently in IPF than in EAA (91.6% versus 33.3%). In IPF cases, the extension of the fibrosis--evaluated with the visual score method--was higher then in EAA (34.7% versus 6%). The presence of fibrosis with basal and peripheral distribution was characteristic of idiopathic pulmonary fibrosis, with good sensitivity and specificity (75%), whereas in chronic extrinsic allergic alveolitis the areas of fibrosis often presented an irregular and heterogeneous distribution, in 91.6% of cases. However, 25% of extrinsic allergic alveolitis cases had a distribution mimicking idiopathic pulmonary fibrosis. The presence of areas with increased ground-glass opacity is more common in EAA than in IPF (66.6% versus 33.3%). Areas of mosaic attenuation, visible in inspiratory CT scans, are not rare in IPF (41.6% of cases), and generally have a basal distribution. The presence of hyperlucent lobules inside the fibrotic areas does not exclude the diagnosis of IPF. The finding of the expiratory air-trapping is more common in chronic EAA than in IPF, and the extension of this areas is greater in EAA (17.3% versus 6.5%). We found an inverse correlation between the extension of the fibrosis and the expiratory trapping. Signs of emphysema were observed in 25% of cases, wiema were observed in 25% of cases, with equal prevalence and the same extension in IPF and in EAA. All patients were smokers or ex-smokers. Smoking has not been demonstrated to have a protective effect against EAA. The areas of mosaic perfusion during inspiration do not represent a sound criterion for the differential diagnosis between IPF and chronic EAA. In fact, they can also be frequently found in IPF. HRCT can be employed in clinical practice for the differential diagnosis between IPF and chronic EAA with good (but not absolute) accuracy.     

Smoking-related interstitial lung diseases: radiologic-pathologic correlation

Smoking-related interstitial lung diseases (SRILD) are a heterogeneous group of entities of unknown cause. These diseases include desquamative interstitial pneumonia (DIP), respiratory-bronchiolitis-related interstitial lung disease (RB-ILD), pulmonary Langerhans’ cell histiocytosis (LCH) and idiopathic pulmonary fibrosis (IPF). High-resolution CT is highly sensitive in the detection of abnormalities in the lung parenchyma and airways. Ground-glass attenuation can occur in DIP and RB-ILD. Whereas DIP is histologically characterized by intra-alveolar pigmented macrophages, RB-ILD shows alveolar macrophages in a patchy peribronchiolar distribution. LCH shows nodular infiltrates on histopathological examination containing varying amounts of characteristic Langerhans’ histiocytes. The HRCT findings are characteristically bilateral, symmetrical and diffuse, involving the upper lobe zones with sparing of the costophrenic angles. The most prominent CT features are nodules (sometimes cavitary) measuring 1 to 10 mm in diameter, cysts and areas of ground-glass attenuation. Pathologically, IPF is characterized by its heterogeneity with areas of normal clung, alveolitis and end-stage fibrosis shown in the same biopsy specimen. High-resolution CT findings consist of honeycombing, traction bronchiectasis and intralobular interstitial thickening with subpleural and lower lung predominance. Since coexisting lesions in the same cases have been observed, a better understanding of the different smoking-related interstitial lung diseases (SRILD) allows a more confident and specific diagnosis.     

肺间质性疾病的HRCT表现及相关病理研究

目的：分析肺间质性疾病的HRCT表现及其与病理学的关系。方法：38例经手术病理证实的肺间质纤维化患者和疾病对照组14例分别行HRCT扫描、组织病理学检查（包括HE、Masson氏三色染色）及免疫组化。结果：早期组中肺小叶间隔增厚81.25%，肺内渗出毛玻璃影18.75%，肺内小结节影66.67%，胸膜下曲线12.5%；中、晚期组中肺小叶间隔纡曲、僵直、变形85.71%，支气管血管束纡曲、僵直35.71%，范围较广的肺气肿32.14%，蜂窝肺28.57%，胸膜增厚39.29％。结论：HRCT是一种安全、反映准确、无创性的诊断ILD的手段，经与病理对照、毛玻璃影、小叶间隔增厚，肺内小结节影、网状影和胸膜下曲线是ILD早期征象；而肺小叶间隔纡曲、僵直、变形，支气管血管束纡曲、僵直，范围较广的肺气肿及蜂窝肺是中、晚期的征象。     

特发性肺纤维化的高分辨率CT评价

目的 评价高分辨率CT（HRCT）对特发性肺纤维化（IPF）的诊断及鉴别诊断的价值,探讨病程与HRCT表现之间的关系。材料与方法 经临床及病理证实的29例IPF患者常规CT检查后对兴趣区行HRCT扫描,观察病变的分布及HRCT表现,并按病程在1年以下、1－2年、2－3年及3年以上分为4组,分析病程与HRCT表现之间的关系。结果 IPF的主要HRCT表现：（1）磨玻璃样密度影;（2）肺小叶间隔增厚;（3）小叶内间质增厚;（4）小叶结构变形;（5）蜂窝肺;（6）交界面不规则;（7）胸膜增厚。小叶间隔增厚及小叶内间质增厚。病程在2年以上分别占72％（21／29）及86％（12／14）。蜂窝肺病程在3年以上占60％（12／20）。病变呈周围型分布。结论 HRCT能细致、准确地反映IPF的大体病理变化,但各种征象均可见于其他各种间质性疾病,小叶间隔增厚及小叶间质增厚伴有肺结构变形和病变的周围型分布对诊断和鉴别诊断较有意义。诊断须结合临床并除外其他原因引起的肺纤维化。     

以孤立小结节为表现的肺癌CT诊断

目的　探讨CT对≤ 2cm ,以孤立小结节为表现的周围型小肺癌CT诊断。方法　搜集 2 0例经手术、穿刺活检和痰检等病理证实的周围型小肺癌的完整CT资料 ,进行回顾性分析。结果　 2 0例小肺癌的主要CT表现 :全部为孤立小结节 ,16例有分叶征、13例有毛刺征并同时具有“毛虫”征、12例有胸膜凹陷征、8例有血管集中征、3例有空气支气管征和空泡征、3例有模糊绒毛影等。结论　CT ,特别是HRCT靶视野扫描[1 ] 对孤立结节性小肺癌的诊断有价值     

Chronic interstitial pneumonia in young patients undergoing lung transplantation or autopsy: clinico-radiologic-pathologic observations from a single institution

Purpose

To retrospectively evaluate high-resolution computed tomography (HRCT) findings and clinical diagnoses of chronic interstitial pneumonia (IP) with a poor prognosis in young patients (≤50 years).

Materials and methods

HRCT images of 8 men and 7 women (mean age 34.8 years) obtained before lung transplantation or autopsy were reviewed. After reviewing whole lung specimens and pathologic diagnoses, all patients were clinically diagnosed according to the 2010 idiopathic pulmonary fibrosis/usual interstitial pneumonia (IPF/UIP) consensus statement.

Results

HRCT images revealed intralobular reticular opacity, air cysts, ground glass opacity, traction bronchiectasis, and interlobular septal thickening. Intralobular reticular opacity was the most extensive finding. Abnormal findings existed predominantly in both the peripheral and lower lung zones in only 1 patient. Classifications of HRCT patterns were “UIP” (n = 2), “inconsistent with UIP” (n = 11), and “indeterminate UIP” (n = 2). Multidisciplinary diagnoses were “IPF/UIP” (n = 1), “possible IPF/UIP” (n = 1), “IP with connective tissue disease” (n = 7), “fibrotic nonspecific IP” (n = 1), and “unclassified IP” (n = 5).

Conclusion

The most extensive HRCT finding was intralobular reticular opacity. Most HRCT images differed from typical IPF/UIP, and IPF/UIP was uncommon in young patients with chronic IP with a poor prognosis.

     

40岁以下肺癌患者病理类型及CT影像学表现

目的 分析40岁以下肺癌患者的病理类型及分化程度,评价CT影像学表现特征及其诊断价值.资料与方法 回顾性分析2009-01～12共80例经病理诊断为肺癌的40岁以下患者的临床及影像学资料.结果 患者从出现症状到明确诊断平均(4.4±0.4)个月,确诊时出现转移63例,占78.75％;腺癌50例,小细胞癌23例,鳞癌5例,细支气管肺泡癌1例,大细胞癌1例.其中36例可辨别分化程度,中高分化3例,中分化15例,中低分化7例,低分化11例;中央型肺癌38例,CT表现为支气管截断或狭窄33例,分叶16例,肺不张及阻塞性炎症23例;周围型肺癌42例,CT表现为分叶34例,毛刺22例,血管集束16例,胸膜凹陷17例.结论 40岁以下人群肺癌以腺癌和小细胞癌为主,其中中央型肺癌以小细胞肺癌及腺癌为主,周围型肺癌以腺癌为主,分化程度较差;患者确诊时多发生转移.     

风湿性肺病的HRCT表现

目的:探讨风湿性肺部病变HRCT表现的一般特征。材料和方法:分析308例风湿病的肺HRCT图像,观察病变的分布特点、肺与支气管病变的形态特点。结果:风湿性肺病的病变分布主要为周边分布(63.6％)、偏后侧分布(57.8％)及膈上肺底分布(61.4％)。本组大多数肺部病变表现为磨玻璃影(68.9％)及线样结构(59.4％),部分病例可伴有网状改变或蜂窝影(32.2％)及界面征(34.1％)。风湿病大支气管及小支气管的受累率分别为1.9％和32.5％(χ~2=96.54,P<0.01)。马赛克灌注的检出率在吸气、呼气相扫描上分别为15.3％、25.6％(χ~2=10.35,P<0.01)。结论:风湿性肺病HRCT表现有一定的特征。病变分布主要位于周边、偏后侧及膈上区域;肺部病变表现主要为磨玻璃影、线样结构、网状改变或蜂窝影及界面征等;支气管病变主要累及小支气管。     

Pulmonary paracoccidioidomycosis and AIDS: high-resolution CT findings in five patients

OBJECTIVE: To study the high-resolution computed tomographic (HRCT) findings in patients with AIDS and pulmonary paracoccidioidomycosis (PCM). MATERIALS AND METHODS: The study included 5 consecutive patients (4 men and 1 woman, with ages ranging between 35 and 57 years; mean, 48 years) with diagnosis of AIDS and pulmonary PCM. All patients underwent HRCT, and the images were reviewed by 2 radiologists who reached decisions by consensus. RESULTS: The predominant HRCT findings in the present series were large nodules (80%), cavited air-space consolidations (80%), ground-glass attenuation (80%), and cicatricial emphysema in the bases (80%). These lesions predominated bilaterally in the middle regions (80%) of the lungs. CONCLUSIONS: The most common HRCT features in patients with AIDS and pulmonary PCM are large nodules associated with cavitated air-space consolidations and ground-glass attenuation, as well as cicatricial emphysema in the pulmonary bases. These findings are usually distributed bilaterally in the middle lung zones of the lungs.