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

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*

PURPOSE: Flexible bronchoscopy is an important diagnostic and sometimes therapeutic tool that can be used on infants and children using light sedation and local anaesthesia. The purpose of this study is to evaluate the contribution of the flexible bronchoscopy to clinical diagnosis and therapy in children. METHODS: We examined the first 100 consecutive flexible bronchoscopies performed in children under 15 years of age(median age, 7 years). RESULTS: Indications for bronchoscopy were bronchoalveolar lavage(39.3%), wheezing(12.5%), stridor/noisy breathing(10.7%), recurrent/persistent pneumonia(8.0%), atelectasis or bronchial toilet (7.1%), equivocal airway foreign body(6.3%), hemoptysis(4.5%), and miscellaneous other reasons (11.6%). Inspection was abnormal in 79.0% of all investigations and made a clinically meaningful contribution to diagnosis in 79.0%. Bronchoalveolar lavage cytology was abnormal in 77.3% of the 44 lavages. Viruses and bacteria were isolated in 33.3% of the 48 specimens cultured. Meaningful therapeutic result was obtained in 81.3% of the 16 therapeutic bronchoscopies including bronchial toilet and persistent atelectasis. CONCLUSION: A high yield of meaningful diagnostic information and therapeutic goal can be expected from flexible bronchoscopy in children.
Bacteria ; Bronchoalveolar Lavage ; Bronchoscopy* ; Child ; Diagnosis ; Humans ; Infant ; Pulmonary Atelectasis ; Therapeutic Irrigation

BACKGROUND: Little information is available concerning the value of bronchoscopy in patients with a lymphocytic exudative pleural effusion in which percutaneous pleural biopsy have been regarded as cornerstone in investigating the etiology. Recenfly, a few reports suggest that bronchoscopy may be more effective diagnostic method in patients with unexplained pleural effusion accompanied by hemoptysis or other roentgenographic abnormalities, such as mass, infiltrate, atelectasis. METHOD: After initial examinations of sputum and pleural fluid through thoracentesis in 112 patients(male 75 cases, female 37 cases, mean age 53.2 years) who were admitted for evaluation of the cause of pleural effusion, we performed bronchoscopy and closed pleural biopsy in most patients with undiagnosed lymphocytic exudate and compared the diagnostic yield of both invasive methods according to hemoptysis or other roentgenographic abnormalities, and investigated the sole diagnostic contribution of bronchoscopy. RESULTS: Tuberculosis(57 cases, 51%) was the most common cause of pleural effusion Percutaneous pleural biopsy showed more diagnostic yield than bronchoscopy regardless of presence or absence of other clinical or radiologic abnormalities. In 25 cases with unknown etiology after pleural biopsy, additional diagnostic yield by bronchoscopy was 36% (4/11) in patients with associated features and only 7% (1/14) with lone effusion, and, as the sole mean for diagnsosis in all patients with pleural effusion, was only 4.5% (5/12) Condusion: In a region of high prevalence of tuberculosis as a cause of pleural effusion, percutaneous pleural biospy is more effective method when invasive method is required for confirmative diagnosis of unexplained lymphocytic exudative pleural effusion, and bronchoscopy is unlikely to aid in the diagnosis of lone pleural effusion.
Biopsy ; Bronchoscopy* ; Diagnosis ; Exudates and Transudates ; Female ; Hemoptysis ; Humans ; Pleural Effusion* ; Prevalence ; Pulmonary Atelectasis ; Sputum ; Tuberculosis