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Pearls and Pitfalls in THORACIC IMAGING Pearls and Pitfalls in THORACIC IMAGING Variants and Other Difficult Diagnoses Edited by Thomas Hartman MD ProfessorofRadiology AssociateChairforEducation MayoClinicDepartmentofRadiology Rochester,MN,USA cambridge university press Cambridge,NewYork,Melbourne,Madrid,CapeTown, Singapore,Sa˜oPaulo,Delhi,Tokyo,MexicoCity CambridgeUniversityPress TheEdinburghBuilding,CambridgeCB28RU,UK PublishedintheUnitedStatesofAmericabyCambridgeUniversityPress,NewYork www.cambridge.org Informationonthistitle:www.cambridge.org/9780521119078 #MayoFoundationforMedicalEducationandResearch Thispublicationisincopyright.Subjecttostatutoryexception andtotheprovisionsofrelevantcollectivelicensingagreements, noreproductionofanypartmaytakeplacewithout thewrittenpermissionofCambridgeUniversityPress. Firstpublished2011 PrintedintheUnitedKingdomattheUniversityPress,Cambridge AcatalogrecordforthispublicationisavailablefromtheBritishLibrary LibraryofCongressCataloging-in-PublicationData Pearlsandpitfallsinthoracicimaging:variantsandotherdifficultdiagnoses/ editedbyThomasHartman. p.; cm. Includesbibliographicalreferencesandindex. ISBN978-0-521-11907-8(Hardback) 1. Chest–Imaging–Casestudies. 2. Chest–Diseases–Diagnosis–Casestudies. I. Hartman,Thomas,1961– II. Title. [DNLM: 1. ThoracicDiseases–diagnosis–CaseReports. 2. Diagnosis,Differential–Case Reports. 3. Tomography,X-RayComputed–CaseReports. WF975] RC941.P432011 617.5040757–dc22 2011008962 ISBN978-0-521-11907-8Hardback CambridgeUniversityPresshasnoresponsibilityforthepersistenceor accuracyofURLsforexternalorthird-partyinternetwebsitesreferredto inthispublication,anddoesnotguaranteethatanycontentonsuch websitesis,orwillremain,accurateorappropriate. Everyefforthasbeenmadeinpreparingthisbooktoprovideaccurateand up-to-dateinformationwhichisinaccordwithacceptedstandardsand practiceatthetimeofpublication.Althoughcasehistoriesaredrawnfrom actualcases,everyefforthasbeenmadetodisguisetheidentitiesofthe individualsinvolved.Nevertheless,theauthors,editorsandpublisherscan makenowarrantiesthattheinformationcontainedhereinistotallyfree fromerror,notleastbecauseclinicalstandardsareconstantlychanging throughresearchandregulation.Theauthors,editorsandpublishers thereforedisclaimallliabilityfordirectorconsequentialdamagesresulting fromtheuseofmaterialcontainedinthisbook.Readersarestrongly advisedtopaycarefulattentiontoinformationprovidedbythemanufacturer ofanydrugsorequipmentthattheyplantouse. To Mary and Emily, myPearls. Contents List of contributors ix Preface 1 Section 1 Airways Case 25 Mycetoma Thomas Hartman 66 Case 26 Roundedatelectasis DavidLevin and Case 1 Tracheal diverticulum/paratracheal aircysts Thomas Hartman 68 Thomas Hartman 2 Case 2 Tracheal bronchusThomas Hartman 4 Section 3 Mediastinum Case 3 Relapsing polychondritis Thomas Hartman 6 Case 4 Tracheobronchopathia osteochondroplastica Case 27 Pneumomediastinum John Hildebrandt 70 Thomas Hartman 10 Case 28 Fibrosingmediastinitis John Hildebrandt 72 Case 5 Tracheobronchomegaly Thomas Hartman 12 Case29 ExtramedullaryhematopoiesisJohnHildebrandt 74 Case 6 Bronchial atresiaThomas Hartman 14 Case 30 Thymolipoma John Hildebrandt 76 Case 7 Dysmotile cilia syndrome(Kartagener’s) Case 31 Mature teratoma John Hildebrandt 78 Thomas Hartman 18 Case32 MediastinalbronchogeniccystJohnHildebrandt 80 Case 8 Williams-Campbell syndrome Case 33 Lateral meningoceles John Hildebrandt 82 Thomas Hartman 20 Case34 PeripheralnervesheathtumorsJohnHildebrandt 84 Case 9 Horseshoe lung Thomas Hartman 22 Section 4 Esophagus Section 2 Lung parenchyma Case 35 Fibrovascular polypJohn Barlow 88 Case 10 SarcoidosisThomas Hartman 24 Case 36 Duplication cyst John Barlow 90 Case 11 Lymphangioleiomyomatosis(LAM) Case 37 Pulsion (epiphrenic) diverticulum John Barlow 92 Thomas Hartman 26 Case 38 Traction diverticulum John Barlow 94 Case12 PulmonaryLangerhanscellhistiocytosisDavidLevin Case 39 Esophageal downhill varicesJohn Barlow 96 and Thomas Hartman 30 Case 40 Esophageal uphill varicesJohn Barlow 98 Case 13 Transbronchial biopsylung injury Case 41 Esophageal mural thickeningJohn Barlow 100 Thomas Hartman 34 Case 42 Esophageal dilatationJohn Barlow 104 Case 14 Congenital cystic adenomatoid malformation DavidLevin and Thomas Hartman 36 Section 5 Aorta Case15 LymphocyticinterstitialpneumoniaDavidLevinand Thomas Hartman 38 Case 43 Penetrating atheromatous ulcerPatrick Eiken 108 Case 16 Intralobar sequestrationDavidLevin and Case 44 Intramuralhematoma Patrick Eiken 110 Thomas Hartman 40 Case 45 AorticdissectionPatrick Eiken 114 Case 17 Erdheim-Chesterdisease David Levin and Case 46 Aortictransection Patrick Eiken 118 Anne-Marie Sykes 44 Case 47 Coarctation and pseudocoarctation of the aorta Case 18 Exogenous lipoid pneumonia DavidLevin and Patrick Eiken 122 Thomas Hartman 48 Case 48 Double aortic archPatrick Eiken 124 Case 19 Pulmonary alveolarproteinosis DavidLevin and Case 49 Rightaortic archPatrick Eiken 128 Thomas Hartman 50 Case 50 Pulmonary sling Patrick Eiken 132 Case 20 Alveolarmicrolithiasis David Levin and Case 51 Takayasu’sarteritisPatrick Eiken 134 Thomas Hartman 52 Case 21 Metastaticpulmonarycalcification David Levin and Thomas Hartman 56 Section 6 Vascular Case 22 Pulmonary hamartoma Thomas Hartman 58 Case 23 Carney’striad/pulmonarychondromas Case 52 Unilateral absenceofa pulmonary artery(UAPA) Thomas Hartman 60 Anne-Marie Sykes 136 Case 24 Mycobacterium avium-intracellularecomplex Case 53 Partial anomalouspulmonaryvenousreturn (MAC)infection Thomas Hartman 64 (PAPVR) Anne-MarieSykes 138 vii Contents Case 54 Pulmonary arteriovenous malformations (PAVMs) Section 9 Diaphragm Anne-Marie Sykes 142 Case 55 Pulmonary artery sarcomaAnne-MarieSykes 146 Case 70 Morgagnihernia RebeccaLindell 186 Case 56 Intravascular tumoremboli Case 71 Bochdalek hernia RebeccaLindell 190 Anne-Marie Sykes 148 Case 57 Pulmonary veno-occlusivedisease Section 10 Lymphatics Anne-Marie Sykes 150 Case 58 Persistent left SVCJohn Hildebrandtand Case 72 Prominentcysterna chyli John Hildebrandt 192 Thomas Hartman 154 Case 73 Diffuse pulmonary lymphangiomatosis Case 59 SVC syndromeJohn Hildebrandt 158 John Hildebrandt 193 Case 60 Prominentsuperior intercostal vein Case74 LymphangiticcarcinomatosisJohnHildebrandt 194 John Hildebrandt 160 Case 61 Azygos continuation of theIVC Section 11 PET/CT John Hildebrandt 162 Case 75 Pulmonary nodule misregistration on PET/CT Section 7 Pericardium Patrick Peller 196 Case 76 Hotclot artifact Patrick Peller 198 Case 62 Recessesofthe pericardium Case 77 Brownfat on PET/CT Patrick Peller 202 RebeccaLindell 164 Case78 PulmonaryLangerhanscellhistiocytosison PET/CT Case 63 Pericardialeffusion RebeccaLindell and Patrick Peller 204 Thomas Hartman 168 Case 79 Talc pleurodesison PET/CT Patrick Peller 206 Case 64 PericardialcystsRebeccaLindell and Case 80 Esophagitis on PET/CTPatrick Peller 208 Thomas Hartman 170 Case 81 Takayasu’sarteritison PET/CT Patrick Peller 212 Case 65 Partial orcomplete absenceof the pericardium RebeccaLindell 172 Section 12 Artifacts Section 8 Pleura Case 82 Windowandlevelsettings Thomas Hartman 214 Case 83 Stair step artifacts Anne-MarieSykes 216 Case 66 Pleural lipoma RebeccaLindell 176 Case 84 Streakartifacts Anne-MarieSykes 217 Case 67 Prominentsubpleural fat with chronic pleural Case 85 Respiratory motionAnne-MarieSykes 218 disease Thomas Hartman 178 Case 86 Lung reconstruction algorithm Case 68 Benign fibroustumorof the pleura (þ/(cid:2) pedicles) Anne-Marie Sykes 220 RebeccaLindell and Thomas Hartman 180 Case 69 Talc pleurodesisRebeccaLindell 182 Index 222 viii

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How often have you been confronted with an image on a thoracic CT exam where you knew it didn't look 'normal', but you weren't sure whether it was 'abnormal' either? And if it is abnormal, is there a specific diagnosis you should be able to make directly off the images? Pearls and Pitfalls in Chest
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236 Pages·2011·20.55 MB·English
by  Thomas Hartman
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How often have you been confronted with an image on a thoracic CT exam where you knew it didn't look 'normal', but you weren't sure whether it was 'abnormal' either? And if it is abnormal, is there a specific diagnosis you should be able to make directly off the images? Pearls and Pitfalls in Chest

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