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Imaging

Last 50 Imaging Postings

(Click on title to be directed to posting, most recent listed first, CME offerings in bold)

Medical Image of the Week: Pulmonary Artery Dilation
Medical Image of the Week: Plastic Bronchitis
January 2018 Imaging Case of the Month
Medical Image of the Week: Pulmonary Alveolar Proteinosis
Medical Image of the Week: Fat Embolism
Medical Image of the Week: Central Venous Access with Dextrocardia
Medical Image of the Week: Mucous Plugs Forming Airway Casts
Medical Image of the Week: Barium Aspiration
December 2017 Imaging Case of the Month
Medical Image of the Week: Yellow Nail Syndrome
Medical Image of the Week: Moyamoya Disease
Medical Image of the Week: Lemierre Syndrome
Medical Image of the Week: Chemotherapy-Induced Diffuse Alveolar 
   Hemorrhage
November 2017 Imaging Case of the Month
Medical Image of the Week: Erythema Nodosum
Medical Image of the Week: Pulmonary Mycetoma
Medical Image of the Week: Pulmonary Infarction- the “Reverse Halo Sign”
Medical Image of the Week: Pulmonary Artery Sling
Medical Image of the Week: Hypertensive Emergencies
October 2017 Imaging Case of the Month
Medical Image of the Week: Typical Pulmonary CT Findings Following 
   Radiotherapy
Medical Image of the Week: Pembrolizumab-induced Pneumonitis
Medical Image of the Week: Asbestos Related Pleural Disease
Medical Image of the Week: Fast-growing Primary Malignant Mediastinal 
   Mixed Germ Cell Tumor
September 2017 Imaging Case of the Month
Medical Image of the Week: The Atoll Sign in Cryptogenic Organizing 
   Pneumonia
Medical Image of the Week: Cannon V Waves
Medical Image of the Week: Bilateral Vocal Cord Paralysis
Medical Image of the Week: Tortuosity of Thoracic Aorta Mimicking a Lung
   Mass
August 2017 Imaging Case of the Month
Medical Image of the Week: Portal Vein Thrombosis in a Patient with
   Polycythemia Vera
Medical Image of the Week: Coral Reef Aorta
Medical Image of the Week: Hematopneumatoceles from Pulmonary 
   Lacerations
Medical Image of the Week: Idiopathic Subglottic Stenosis
July 2017 Imaging Case of the Month
Medical Image of the Week: Zenker’s Diverticulum
Medical Image of the Week: Superior Sulcus Tumor with Neural Invasion
Medical Image of The Week: Urothelial Carcinoma with Pulmonary
   Metastases Presenting with Shoulder Pain
Medical Image of the Week: Spontaneous Pneumothorax in End Stage
   Fibrotic Lung Disease
Medical Image of the Week: Saber Sheath Trachea
June 2017 Imaging Case of the Month
Medical Image of the Week: Coronary Artery Ectasia
Medical Image of the Week: Lymphangitic Carcinomatosis
Medical Image of the Week: Type A Aortic Dissection Extending Into Main 
   Coronary Artery 
The “Hidden Attraction” of Cardiac Magnetic Resonance Imaging for 
   Diagnosing Pulmonary Embolism
Medical Image of the Week: Pulmonary Vein Thrombosis
May 2017 Imaging Case of the Month
Medical Image of the Week: A Positive Sniff Test
Medical Image of the Week: Staphylococcal Pneumonia in a Patient with
   Influenza
Medical Image of the Week: Bronchopulmonary Sequestration
Medical Image of the Week: Wolff-Parkinson-White Syndrome
Medical Image of the Week: DISH with OPLL and C3 Fracture
April 2017 Imaging Case of the Month
Medical Image of the Week: Artery of Percheron Infarction

 

For complete imaging listings click here.

Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary and Critical Care publishes case-based articles with characteristic chest imaging and related pathology. The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend. Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary and Critical Care publishes case-based articles with characteristic chest imaging and related pathology. The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend.

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Wednesday
Jan172018

Medical Image of the Week: Pulmonary Artery Dilation

Figure 1.  Axial section of the thoracic CT scan showing the massively dilated pulmonary trunk and artery.

The upper limit of the normal diameter of the main pulmonary artery on CT scan is 29 mm and of the right interlobar artery is 17 mm (1). A dilated pulmonary artery can arise from a variety of disease states. Most commonly from one of the many causes of pulmonary hypertension including idiopathic, previously termed primary, pulmonary artery hypertension (PAH). Other less common causes of pulmonary arterial dilation include pulmonary valvular stenosis, atrial septal defect, and idiopathic dilatation of the pulmonary artery.

Our patient is 66-year-old man with exertional dyspnea who was found to have a dilated pulmonary artery on thoracic CT scan during his work up (Figure 1).  His case is suspected to be idiopathic dilatation (1). This is a rare disease with estimates around 0.6% of patients with known congenital heart disease. The estimates in the general population are unknown. There have been a few different diagnostic criteria proposed, but most contain the following:

  1. Dilation of the pulmonary trunk 
  2. Absence of abnormal intracardiac or extracardiac shunts
  3. Absence of chronic heart or lung disease
  4. Absence of arterial diseases such as syphilis, arteriosclerosis or arteritis
  5. Normal pressures in the right ventricle and pulmonary artery

Patients are usually asymptomatic or with minimal symptoms of dyspnea such as our patient. Rarely, it can present dramatically from compression of nearby structures. This includes constriction of the trachea or major branches or sudden cardiac death from compression of the left main coronary artery.

Tiffany Ynosencio MD and Swathy Puthalapattu MD

Division of Pulmonary, Allergy, Critical Care and Sleep

Banner-University Medical Center and Southern Arizona VA Health Care System

Tucson, AZ USA

Reference

  1. Malviya A, Jha PK, Kalita JP, Saikia MK, Mishra A. Idiopathic dilatation of pulmonary artery: A review. Indian Heart J. 2017 Jan-Feb;69(1):119-24. [CrossRef] [PubMed]

Cite as: Ynosencio T, Puthalapattu S. Medical image of the week: pulmonary artery dilation. Southwest J Pulm Crit Care. 2018;16(1):46-7. doi: https://doi.org/10.13175/swjpcc012-18 PDF 

Wednesday
Jan102018

Medical Image of the Week: Plastic Bronchitis

Figure 1. Cast removed from the right main stem.

 

Figure 2. Casts removed from right lower lobe.

 

Plastic Bronchitis is a rare syndrome characterized with expectoration of bronchial casts.  Conditions associated with plastic bronchitis in adults include asthma, allergic bronchopulmonary aspergillosis, cystic fibrosis, bronchiectasis, tuberculosis, amyloidosis, sickle cell anemia and rheumatoid arthritis. In children, is its associated with congenital heart diseases (1).

Typical casts are large and branched. These can be expectorated or removed endoscopically as in our case of a 52-year old man with respiratory failure (Figures 1 and 2). The exact etiology of his plastic bronchitis remains obscure. These casts were removed using a bronchoscope with a cryotherapy probe. 

Lauren Estep MD and Bhupinder Natt MD FACP

Division of Pulmonary, Allergy, Critical Care and Sleep

Banner-University Medical Center, Tucson, AZ USA

Reference

  1. Itkin MG, McCormack FX, Dori Y. Diagnosis and treatment of lymphatic plastic bronchitis in adults using advanced lymphatic imaging and percutaneous embolization. Ann Am Thorac Soc. 2016 Oct;13(10):1689-96. [CrossRef] [PubMed]

Cite as: Estep L, Natt B. Medical image of the week: plastic bronchitis. Southwest J Pulm Crit Care. 2018;16(1):28. doi: https://doi.org/10.13175/swjpcc005-18 PDF