PURPOSE: The purposes of this study are to discribe the high-resolution computed tomographic (HRCT) findings of pulmonary histiocytosis X and to evaluate the relationship between the extent of the lesion on HRCT and pulmonary function test (PFT). MATERIALS AND METHODS: We retrospectively analyzed the HRCT findings of 8 patients with pathologically proved pulmonary histiocytosis X. The morphological pattern and incidence of the lesions were evaluated. The extent of the lesions were correlated with the results of PFT by calculating Spearman correlation. RESULTS: The most common HRCT findings were thick-walled cysts (n=8) followed by nodules (n=7). Other associated findings were reticulation, ground-glass opacification, and conglomerate nodules. The extent of the disease on HRCT was correlated inversely with percent predicted value of functional vital capacity. CONCLUSION: Common HRCT findings of pulmonary histiocytosis X were cysts with irregular wall thickening and nodules. The extent of the disease on HRCT correlated with the severity of restrictive pattern of PFT.
Histiocytosis, Langerhans-Cell* ; Humans ; Incidence ; Respiratory Function Tests ; Retrospective Studies ; Vital Capacity

PURPOSE: The incidence of lung cancer in patients with idiopathic pulmonary fibrosis(IPF) is higher than that of general population. To evaluate the frequency and CT findings of lung cancer associated with idiopathic pulmonary fibrosis, we analyzed 19 patients with lung cancer associated with idiopathic pulmonary fibrosis. MATERIALS AND METHODS: We analyzed retrospectively 19 patients with histologically confirmed lung cancer out of 208 patients diagnosed as IPF either by CT and clinical findings(n=188) or histologically(n=20). All 19 patients were male, aged 40--85 years (mean 66 years). Scanning techniques were conventional CT in 12 patients, HRCT in 1 patient and both conventional CT and HRCT in 6 patients. We analyzed the CT patterns of lung cancer and IPF, locations of the tumor and histologic types of lung cancer. RESULTS: The incidence of lung cancer in patients with idiopathic pulmonary fibrosis was 9.1%(19/208). In 11 of 19 patients, CT findings of lung cancer were ill-defined consolidation-like mass. Lung cancer was located mainly in lower lobes(right lower Iobe;10/19, left lower Iobe;5/19) and at the periphery(12/19). Histologically, squamous cell carcinoma was the most common cell type (11/19). CONCLUSION: The incidence of lung cancer in patients with idiopathic pulmonary fibrosis was much higher than that of general population. Typical CT findings of lung cancer were predominantly ill-defined consolidation like mass at the peripheral lung portion which is the [ocatiaon where the most advanced fibrosis occur.
Carcinoma, Squamous Cell ; Fibrosis ; Humans ; Idiopathic Pulmonary Fibrosis* ; Incidence ; Lung Neoplasms* ; Lung* ; Male ; Retrospective Studies

The characteristic radiographic and CT findings of Iobar atelectasis are well known. However, Iobar atelectasis is a dynamic process, and atypical presentations may occur due to a number of different causes. Familiarity with the various typical and atypical radiographic findings of Iobar atelectasis is important for correct diagnosis. The aim of this manuscript is to illustrate the spectrum of radiographic findings of Iobar atelectasis and to correlate the radiographic findings with the CT findings. The review will illustrate examples of typical and atypical Iobar atelectasis, including combined Iobar atelectasis, peripheral Iobar atelectasis, migrating Iobar atelectasis, rounded atelectasis involving the entire lobe and Iobar atelectasis mimicking paravertebral and mediastinal masses.
Diagnosis ; Pulmonary Atelectasis* ; Recognition (Psychology)

The characteristic radiographic and CT findings of Iobar atelectasis are well known. However, Iobar atelectasis is a dynamic process, and atypical presentations may occur due to a number of different causes. Familiarity with the various typical and atypical radiographic findings of Iobar atelectasis is important for correct diagnosis. The aim of this manuscript is to illustrate the spectrum of radiographic findings of Iobar atelectasis and to correlate the radiographic findings with the CT findings. The review will illustrate examples of typical and atypical Iobar atelectasis, including combined Iobar atelectasis, peripheral Iobar atelectasis, migrating Iobar atelectasis, rounded atelectasis involving the entire lobe and Iobar atelectasis mimicking paravertebral and mediastinal masses.
Diagnosis ; Pulmonary Atelectasis* ; Recognition (Psychology)

Both idiopathic pulmonary fibrosis (IPF) and pulmonary involvement of collagen vascular disease(CVD) are well known cause of diffuse interstitial lung disease which lead to fibrosis and honeycombing. We analyzed HRCT findings of 33 patients with IPF and 14 patients with CVD in terms of predominant pattern, site of involvement, mediastinal lymph node enlargement, pleural change and pulmonary volume loss. Criteria of mediastinal lymph node enlargement and pleural thickening were 15mm in long diameter and 3mm, respectively. Volume loss of the lung was measured by using hilar height ratio (apex to hilum/hilum to diaphragmatic dome). Mean age was 61 years for IPF and 46 years for CVD and male: female ratio was 27:6, 4:10, respectively. Predominant HRCT pattern was honeycombing for IPF (63%), and ground-glass opacity for CVD (66%) (p=0.001). Predominantly, subpleural involvement was seen in 90% for IPF and 74% for CVD. Mediastinal lymph node enlargement was seen in 47% of the patient with IPF and 14% with CVD (p=0.004). pleural thickening was seen in 97% of the patients with IPF and 42% with CVD (P=0.002), Pleural effusion was seen in 10% of the patients with IPF and 36% with CVD (P=0.009). Hilar height ratio of more than 1.5 was seen in 84% of the patients with IPF and 29% with CVD. In conclusion, our study shows that patients with IPF are prone to have more progressed stage of pulmonary fibrosis than the patients with CVD on HRCT.
Collagen* ; Female ; Fibrosis ; Humans ; Idiopathic Pulmonary Fibrosis* ; Lung ; Lung Diseases, Interstitial ; Lymph Nodes ; Male ; Pleural Effusion ; Pulmonary Fibrosis

The purpose of this study is to evaluate the efficacy of the balloon bronchoplasty in the treatment of the tuberculous bronchostenosis. Balloon bronchoplasty was performed in thirteen patients with stenosis of the left main bronchus (two with combined left upper and lower lobar bronchostenosis) using a inflatable balloon catheter under a fluoroscopic guide. We analysed the changes in the changes in the severity of dyspnea and wheezing, serial FEV1/FVC as a parameter of the airflow obstruction, and bronchial diameter and lung volume on chest radiographs. The extent of pulmonary tuberculosis was correlated with the improvement of FEV1/FVC. There was an improvement of dyspnea in 69%(9/13), decrease of wheezing in 69%(9/13), significant increase of FEV1/FVC in 18% (2/11). The increase of the bronchial diameter and lung volume were seen in 84%(11/13) and 53% (7/13), respectively. The significant increase of FEVI/FVC was seen in 28% (2/7) of the patients with lung involvement of tuberculosis less than one third of left upper lobe, whereas there was no increase in those of more than one third. There was no complication except transient leukocytosis, fever and blood-tinged sputum. In conclusion, balloon bronchoplasty is effective in the treatment of medically intractable tuberculous bronchostenosis, and can be considered as an initial method of treatment.
Bronchi ; Catheters ; Constriction, Pathologic ; Dyspnea ; Fever ; Humans ; Leukocytosis ; Lung ; Methods ; Radiography, Thoracic ; Respiratory Sounds ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary

The purpose of this study is to evaluate the efficacy of the balloon bronchoplasty in the treatment of the tuberculous bronchostenosis. Balloon bronchoplasty was performed in thirteen patients with stenosis of the left main bronchus (two with combined left upper and lower lobar bronchostenosis) using a inflatable balloon catheter under a fluoroscopic guide. We analysed the changes in the changes in the severity of dyspnea and wheezing, serial FEV1/FVC as a parameter of the airflow obstruction, and bronchial diameter and lung volume on chest radiographs. The extent of pulmonary tuberculosis was correlated with the improvement of FEV1/FVC. There was an improvement of dyspnea in 69%(9/13), decrease of wheezing in 69%(9/13), significant increase of FEV1/FVC in 18% (2/11). The increase of the bronchial diameter and lung volume were seen in 84%(11/13) and 53% (7/13), respectively. The significant increase of FEVI/FVC was seen in 28% (2/7) of the patients with lung involvement of tuberculosis less than one third of left upper lobe, whereas there was no increase in those of more than one third. There was no complication except transient leukocytosis, fever and blood-tinged sputum. In conclusion, balloon bronchoplasty is effective in the treatment of medically intractable tuberculous bronchostenosis, and can be considered as an initial method of treatment.
Bronchi ; Catheters ; Constriction, Pathologic ; Dyspnea ; Fever ; Humans ; Leukocytosis ; Lung ; Methods ; Radiography, Thoracic ; Respiratory Sounds ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: To describe the radiological differences between tuberculous(TBB) and non-tuberculous bronchiectasis(NTBB). MATERIALS AND METHODS: Chest radiographs(n=62), bronchograms(n=18), and CT scans(n=52) of 37 patients with TBB and 25 patients with NTBB were reviewed retrospectively. Diagnostic basis for TBB were positive sputum AFB with or without history of anti-tuberculous chemotherapy(n=35), and radiological findings of pulmonary tuberculosis (n=2). Four of NTBB had a history of severe respiratory tract infection in childhood. RESULTS: Air-fluid levels on chest radiographs were seen in 2% of TBB, and 20% of NTBB. On bronchograms, all patients with TBB had combined focal bronchostenosis, whereas patients with NTBB had tubular(50%), cystic(17%), or mixed(33%) pattern of dilatation without stenosis. On CT scans, focal emphysema was seen in 86% of the patients with TBB, and 38% of the patients with NTBB. Peribronchiolar infiltration were seen in 78% and 44% of patients with TBB and NTBB, retrospectively. CONCLUSION: Basic radiological difference between TBB and NTBB was that the former had coexistent sten.
Bronchiectasis* ; Constriction, Pathologic ; Dilatation ; Humans ; Pulmonary Emphysema ; Radiography, Thoracic ; Respiratory Tract Infections ; Retrospective Studies ; Sputum ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary

Effect of acetylcholine(ACh) and McN-A-343 on porcine coronary artery and rabbit thoracic aorta were investigated in isolated preparations with or without intact endothelium. In the porcine coronary artery, ACh produced concentration dependent contraction which was greater in rings without the endothelium than in intact endothelial rings, but McN-A-343 did not alter the basel tension in both tissues. ACh relaxed contraction induced by 5-hydroxytryptamine(5-HT) in only intact endothelial rings, while NcN-A-343 inhibited the 5-HT induced tension in both preparations dose dependently. Carbachol elicited a prominent contraction in both tissues. The carbacol-induced tension was markedly inhibited by McN-A-343 in either rings with or without endothelium, while ACh contracted further the tension. ACh and McN-A-343 did not after the KCi induced tension, but clearly potentiated the contraction induced by Bay K 8644 in intact endothelial rings. In rabbit thoracic aorta, ACh elicited contraction in a concentration-dependent fashion which was potentiated by removal of endothelium, but McN-A-343 did not affect the basal tension of both rings. ACh inhibited the 5-HT-induced contraction in only intact endothelial ring, but McN-A-343 did not change the contraction of both rings. Conclusively, ACh produces endothelium-dependent relaxation in both arteries, while McN-A-343 elevated endothelium-independent inhibition to 5-HT or carbachol-induced tension.
(4-(m-Chlorophenylcarbamoyloxy)-2-butynyl)trimethylammonium Chloride* ; 3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester ; Acetylcholine* ; Aorta, Thoracic ; Arteries* ; Carbachol ; Coronary Vessels ; Endothelium ; Relaxation ; Serotonin

The increase in size of lymph node on Ct scan is the single most important finding of lymphadenopathy. The purpose of this study was to evaluate the size of mediastinal lymph nodes in patients with idiopathic pulmonary fibrosis with no evidence of malignancy or current infection. CT scans of 70 patients (16 with conventional CT and 54 with high-resolution CT) were assessed for lymph node size and locations. The duration of symptoms, and the extent and patterns of the parenchymal lung disease on CT scans were correlated with lymph node enlargement. In 54 of 70 patients, more than one lymph nodes were larger than 1-1.5cm. The prevalence of mnode enlargement increased significantly with a longer duration of symptom (p=0.001), larger extent of the disease (p=0.043), and with a greater proportion of honeycomb pattern (p=0.0344). Right paratracheal, subcarinal, right tracheobronchial, and paraesophageal nodes were the most common sites of nodes enlargement. In conclusion, mediastinal lymph node enlargement is common in patients with idiopathic pulmonary fibrosis and is more frequently seen in patients with a longer duration of clinical symptoms, greater extent of the disease, and with a larger proportion of honeycomb pattern.
Humans ; Idiopathic Pulmonary Fibrosis* ; Lung Diseases ; Lymph Nodes* ; Lymphatic Diseases ; Prevalence ; Tomography, X-Ray Computed*