EURORAD ESR

Case 9074

Scleroderma: A focus on pulmonary findings

Author(s)
Kalra V1, Mirza K2, Shin MS3

[1] Yale University; [2]Ross University School of Medicine; [3]Chest Radiology, Yale University.
 
Patient
female, 58 year(s)
 
 
  • Figure 1
    CXR

    Posteroanterior chest radiograph shows a large, dilated, air-filled esophagus, reticular interstitial lung markings, bilateral lower lobe volume loss, and dilated loops of bowel. No enlargement of the pulmonary...

     
    Area of Interest: Oesophagus; Imaging Technique: Digital radiography;
     
     
  • Figure 2
    Initial CT
     

    Initial CT on lung windows, at the level of the aortic arch demonstrates a dilated oesophagus with an air-fluid level and normal appearing lung parenchyma.

     
    Area of Interest: Oesophagus; Imaging Technique: CT; Special Focus: Dilatation;

    Soft tissue windows demonstrate mild dilation of the pulmonary arteries. This is evidenced by the diameter of the main pulmonary artery equaling the adjacent aortic root. Air-fluid level in the oesophagus is seen.

     
    Area of Interest: Pulmonary vessels; Imaging Technique: CT; Special Focus: Dilatation;
     
     
  • Figure 3
    High resolution CT chest performed 6 months later
     

    Sequential 1.25mm axial HRCT images. Peripheral, subpleural groundglass opacity, prominent reticular markings, and traction bronchiectases are seen with lower lobe predominance consistent with nonspecific interstitial...

     
    Area of Interest: Lung; Imaging Technique: CT-High Resolution;

    Sequential 1.25mm axial HRCT images. Peripheral, subpleural groundglass opacity, prominent reticular markings, and traction bronchiectases are seen with lower lobe predominance consistent with nonspecific interstitial...

     
    Area of Interest: Lung; Imaging Technique: CT-High Resolution;

    Sequential 1.25mm axial HRCT images. Peripheral, subpleural groundglass opacity, prominent reticular markings, and traction bronchiectases are seen with lower lobe predominance consistent with nonspecific interstitial...

     
    Area of Interest: Lung; Imaging Technique: CT-High Resolution;
     
     
  • Figure 4
    HRCT Coronal reformat

    The 5 mm thick coronal reformat shows peripheral, subpleural groundglass opacity, prominent reticular markings, and traction bronchiectasis with lower lobe predominance consistent with nonspecific interstitial...

     
    Area of Interest: Lung; Imaging Technique: CT-High Resolution;
     
     
Posteroanterior chest radiograph shows a large, dilated, air-filled esophagus, reticular interstitial lung markings, bilateral lower lobe volume loss, and dilated loops of bowel. No enlargement of the pulmonary arteries can be appreciated.
 
Initial CT on lung windows, at the level of the aortic arch demonstrates a dilated oesophagus with an air-fluid level and normal appearing lung parenchyma.
 
Soft tissue windows demonstrate mild dilation of the pulmonary arteries. This is evidenced by the diameter of the main pulmonary artery equaling the adjacent aortic root. Air-fluid level in the oesophagus is seen.
 
Sequential 1.25mm axial HRCT images. Peripheral, subpleural groundglass opacity, prominent reticular markings, and traction bronchiectases are seen with lower lobe predominance consistent with nonspecific interstitial pneumonia (NSIP) and patient’s history of scleroderma.
 
Sequential 1.25mm axial HRCT images. Peripheral, subpleural groundglass opacity, prominent reticular markings, and traction bronchiectases are seen with lower lobe predominance consistent with nonspecific interstitial pneumonia (NSIP) and patient’s history of scleroderma.
 
Sequential 1.25mm axial HRCT images. Peripheral, subpleural groundglass opacity, prominent reticular markings, and traction bronchiectases are seen with lower lobe predominance consistent with nonspecific interstitial pneumonia (NSIP) and patient’s history of scleroderma.
 
The 5 mm thick coronal reformat shows peripheral, subpleural groundglass opacity, prominent reticular markings, and traction bronchiectasis with lower lobe predominance consistent with nonspecific interstitial pneumonia (NSIP) and scleroderma.
 
 
 
Home Search Sections Teaching Cases History FAQ Case Archives Contact Login Disclaimer Imprint Switch to MOBILE version
View desktop version