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)

PURPOSE: To evaluate the CT findings of histologically confirmed endobrnchial tuberculosis(EBTB) and to access their diagnostic value by comparing with the bronchoscopic findings. MATERIALS AND METHOD: We evaluated retrospectively the CT findings of 25 patients(male : female=5 : 20) with EBTB, and classified them into 3 types by their characteristic features, which are compared with the brochoscopic findings. The 3 types of CT features were as follows ; type 1 : central mass-like lesion with coarse calcific spots associated with atelectasis, type 2: caseous pneumonia with air-bronchogram associated with atelecatasis, type 3 : irregularly distorted and narrowed bronchovascular changes. RESULTS: Comparing the characteristic CT findings with the bronchoscopic findings, they were as follows ; type 1 showed completely occluded lumen by caseous or scar-like tissue with severely swollenmucosa, type 2 showed very thick tenacious mucous plug with anthracotic pigmentation of mucosa, type 3 showed chronic inflammatory change of mucosa with severely deviated or septated bronchial lumen by out-growing caseousgranulation tissue. A tracheal tuberculosis without parenchymal lesion was noted and the bronchoscopy showed caseous materials along the tracheal lumen to the carinal level. CONCLUSION: The characteristic CT findings ofthe bronchial wall and the changes of the adjacent tissues are related to the tracheobronchial tuberculous involvement. CT is useful for diagnosis of the endobronchial tuberculosis.
Adult* ; Bronchoscopy ; Diagnosis ; Humans ; Mucous Membrane ; Pigmentation ; Pneumonia ; Pulmonary Atelectasis ; Tuberculosis* ; Tuberculosis, Pulmonary

OBJECTIVEBronchitis obliterans is a severe and extremely rare complication of respiratory tract infections in children and is characterized by massive atelectasis and collapse of the affected lung.

METHODThe clinical manifestations, characteristic imaging of two cases with bronchitis obliterans were summarized.

RESULTThese two cases complained of cough and episodes of wheezing with exercise. Chest auscultation revealed bronchial breath sounds on the right side. High-resolution computed tomography (HRCT) scan showed atelectasis of the right lung and dilated central airways. Mycoplasma complement fixation antibody (CF-Ab) titer was 1:320. The diagnosis of bronchitis obliterans was made according to the current diagnostic criteria. They were treated with low-dose erythromycin [5 mg/(kg × d)], ultrasonically nebulized Pulmicort inhalation, and regular bronchoscopic lavage. Follow-up of the two cases showed that case one had a partial lung re-expansion after six months, but case two had no significant improvement.

CONCLUSIONIn the process of diagnosis of atelectasis, bronchitis obliterans should be noticed. A conservative treatment is effective in certain cases, but pneumonectomy or lobectomy should only be considered as the last option.

Bronchiolitis Obliterans ; diagnosis ; therapy ; Child, Preschool ; Female ; Humans ; Male ; Pulmonary Atelectasis ; diagnosis ; therapy

BACKGROUND: Pulmonary thromboembolism(PTE) is a life threatening disease that needs early diagnosis. Spiral CT angiography depict thromboemboli in the central pulmonary vessels with greater than 90% sensitivity and specificity, which approaches the results of pulmonary angiography in the Prospective Investigation of Pulmonary value(clinical utility) of the spiral CT angiography with 2D image (multiplanar reformation) and 3D images(Shaded surface display, Minimal intensity projection) in the pulmonary thromboembolism. METHODS: We retrospectively analysed spiral CT angiography and prlmonary angiography, lung scan and clinical recordings of 20 patients who had PTE diagnosed by spiral CT angiography(n=19 cases) or pulmonary angiography(n=1 case) from September 1997 to August 1998. Among 20 patients who had underwent spiral CT angiography, 14 patients could be performed lung perfusion scan at the same time. We analyzed the vascular and parenchymal change in spiral CT angiogram. RESULTS: Anatomical distribution of PTE was as follows : 1) left lung(n=103) < right lung(n=129), 2) upper and middle(or lingular) lobe(n=101) < lower lobe(n=116), 3) proximal < distal but 5th order in lower lobe was decreased in distribution. Spiral CT angiography could allow accurate demonstration of 19/20 cases(95%) PTE in our study. Spiral CT angiography could demonstrate acute PTE in 16 patients and chronic PTE in 3 patients. Spiral CT angiography could also showed the combined lung parenchymal lesions(Infarction(n=9 cases), atelectasis(n=4 cases), pleural effusion(n=6 cases)). CONCLUSIONS: Spiral CT angiography with 2D image (multiplanar reformation) and 3D images(shaded surface display, minimal intensity projection) is a noninvasive diagnostic tool in the pulmonary thromboembolism. This method had several advantages; 1) It was showed the distribution of pulmonary embolism in total lung field. 2) It had high sensitivity in diagnosis of pulmonary embolism. 3) It discriminated between acute and chronic PTE. 4) It was showed the associated disease such as lung infarction, atelectasis, pleural effusion. 5) It was correlated with scintigraphic findings.
Angiography* ; Diagnosis* ; Early Diagnosis ; Humans ; Infarction ; Lung ; Perfusion ; Pleural Effusion ; Pulmonary Atelectasis ; Pulmonary Embolism* ; Retrospective Studies ; Tomography, Spiral Computed*

PURPOSE: To assess the CT findings of bronchial anthracofibrosis with or without active tuberculosis. MATERIALS AND METHODS: Analysis of the CT scans of 35 patients with bronchoscopically proven anthracofibrosis revealed that 25 were negative for active tuberculosis and ten were positive. Bronchial and pleural lesions, pulmonary parenchymal lesions, and mediastinal/hilar lymph nodes were retrospectively evaluated. RESULTS: Common radiologic findings of anthracofibrosis included diffuse bronchial narrowing (50%), wall thickening (37%), and mass-like soft tissue density in central bronchi (8%). The right middle lobe was most commonly involved (31%). Common findings of pulmonary parenchymal lesions included consolidation (37%), atelectasis (31%), and ground-glass opacity (10%). These bronchial or pulmonary parenchymal findings were common in patients with or without active tuberculosis. Findings of multiple poorly defined small nodules, including branching opacities and consolidation with internal low density were seen only in patients with active tuberculosis (p<0.01), while enlarged mediastinal or hilar lymph nodes were frequently observed in patients with or without active tuberculosis. Necrotic lymph nodes were present only in those with active tuberculosis (p<0.05). CONCLUSION: When CT scans depict central bronchial narrowing, wall thickening, or mass-like soft tissue density with atelectasis or consolidation, especially in older patients without a distinct central lung mass lesion, anthacofibrosis should be included in the differeatial diagnosis. When multiple poorly defined small nodules, including branching opacities, consolidation with internal low density or necrotic lymph nodes are observed, the possibility of concomitant active tuberculosis should be considered.
Bronchi ; Diagnosis ; Humans ; Lung ; Lymph Nodes ; Pulmonary Atelectasis ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis*

Neurilemmomas are benign tumors that originate from Schwann cells. These tumors rarely occur in the trachea or bronchus. Although small peripheral lesions cause no symptoms, they usually cause dyspnea, cough, wheeze, and atelectasis. We encountered two cases of endobronchial neurilemmoma, and reviewed 10 cases previously reported in Korea in order to clarify the characteristics of this disease, and to determine the appropriate treatment. The median age of the 12 patients reviewed were 36.5 (range 16-75). Cough and dyspnea were the most common initial symptoms (40%), and two cases had no symptoms. Regarding the diagnostic methods, bronchoscopic biopsy was found to be inadequate for diagnosis in two cases. A review of the cases revealed the following teatments: bronchoscopic removal in two cases, surgery in six cases, and combined bronchoscopic removal and surgery in one case.
Biopsy ; Bronchi ; Bronchoscopy ; Cough ; Diagnosis ; Dyspnea ; Humans ; Korea* ; Neurilemmoma* ; Pulmonary Atelectasis ; Schwann Cells ; Trachea

Rupture limited to the lobar bronchus from blunt trauma is especially rare, and the symptoms are light so diagnosis is difficult. In a patient who visited the hospital complaining of shortness of breath after falling down, atelectasis continued in the chest x-ray. Four days after visiting the hospital, a left upper lobar bronchial rupture was diagnosed through a bronchoscopy and 3 dimensional chest computerized tomography. When diagnosis is delayed in the case of a rupture limited to the lobar bronchus, bronchial obstruction can occur from the formation of granulation tissue, so regular monitoring is important. Therefore, when atelectasis continues after blunt trauma, it is important to differentially diagnose a lobar bronchial rupture through tests such as bronchoscopy.
Bronchi ; Bronchoscopy ; Diagnosis ; Dyspnea ; Granulation Tissue ; Humans ; Lung Injury ; Pulmonary Atelectasis* ; Rupture* ; Thorax

Tracheobronchial disruption is one of the most severe injuries caused by blunt chest trauma. It may be followed by bronchial stenosis and subsequent atelectasis. We reviewed two patients with traumatic tracheobronchial injuries sustained after vehicular accident. Bronchial stenosis was suspected due to atelectasis which was first detected 5 days and 11 days after the accident, respectively. They didn't respond to conservative management such as chest physiotherapy for about 2 weeks. Flexible fiberoptic bronchoscopy confirmed bronchial stenosis at the left main bronchus in one patient and at the left upper lobe bronchus in the other. The stenotic bronchi were corrected by resection and end-to-end anastomosis, and bronchoscopy performed postoperatively showed good repair. The patients were discharged without complications. Flexible bronchoscopy is useful and reliable in children as well as in adults for early diagnosis of traumatic tracheobronchial injuries. Resection and end-to-end anastomosis is successful in these cases.
Adult ; Bronchi ; Bronchoscopy* ; Child ; Constriction, Pathologic* ; Early Diagnosis ; Humans ; Pulmonary Atelectasis ; Thorax

Endobronchial lipoma is a rare, benign neoplasm of the large bronchi, which makes up about 0.1 percent of all lung tumors. It can produce irreversible parenchymal lung damage or bronchiectasis if diagnosis and treatment are delayed. The treatment of endobronchial lipoma is early removal and surgical procedures depend on the status of distal parenchymal lung damage. We experienced a case of endobronchial lipoma in 53 year-old female patient, which caused total collapse of left lung and save left lung by enucleation of tumor via bronchotomy.
Bronchi ; Bronchiectasis ; Diagnosis ; Female ; Humans ; Lipoma* ; Lung* ; Middle Aged ; Pulmonary Atelectasis*