Sarcoidosis is a systemic disorder of unknown cause that is characterized by the presence of noncaseating granulomas. The radiological findings associated with sarcoidosis have been well described. The findings include symmetric, bilateral hilar and paratracheal lymphadenopathy, with or without concomitant parenchymal abnormalities (multiple small nodules in a peribronchovascular distribution along with irregular thickening of the interstitium). However, in 25% to 30% of cases, the radiological findings are atypical and unfamiliar to most radiologists, which cause difficulty for making a correct diagnosis. Many atypical forms of intrathoracic sarcoidosis have been described sporadically. We have collected cases with unusual radiological findings associated with pulmonary sarcoidosis (unilateral or asymmetric lymphadenopathy, necrosis or cavitation, large opacity, ground glass opacity, an airway abnormality and pleural involvement) and describe the typical forms of the disorder as well. The understanding of a wide range of the radiological manifestations of sarcoidosis will be very helpful for making a proper diagnosis.
Diagnosis, Differential ; Humans ; Lymph Nodes/pathology ; Radiography, Thoracic ; Sarcoidosis, Pulmonary/pathology/*radiography ; Thoracic Diseases/pathology/*radiography ; *Tomography, X-Ray Computed

Extranodal marginal zone lymphoma is a low-grade B cell lymphoma that presents with an indolent clinicopathologic nature. Although this tumor can occur in various sites, including the gastrointestinal tract and lungs, it develops and spreads extremely rarely along the trachea and central airway. We report a case of extranodal lymphoma of mucosa-associated lymphoid tissue with tracheobronchial involvement. An 83-year-old woman presented with a cough and dyspnea. Bronchoscopic evaluation confirmed diffuse, multiple nodular lesions in both the trachea and large bronchi, and she was diagnosed with an extranodal marginal zone lymphoma of the tracheobronchial tree. After systemic chemotherapy, she survived for more than 18 months.
Aged, 80 and over ; Bronchial Diseases/drug therapy/*pathology/radiography ; Female ; Humans ; Lymphoma, B-Cell, Marginal Zone/drug therapy/*pathology/radiography ; Radiography, Thoracic ; Tracheal Diseases/drug therapy/*pathology/radiography

Forty canine patients with a presumptive diagnosis of the intervertebral disc herniation at the thoracolumbar region were imaged. A neurological examination was performed and all patients were classified under four grades by the examination. The degrees of attenuation of the herniated disc material were measured in Housefield units (HU) in each image. The ratio of the area to herniated disc material and the height to disc material were measured. The clinical grade was correlated with the area ratio of the herniated disc material to the spinal cord, but not correlated with the height ratio of that. In the patients with epidural hemorrhage at surgery, HUs of the herniated disc material was lower than those with no epidural hemorrhage at surgery. Non-contrast computed tomography scans of the spine can be useful in diagnosing acute intervertebral disc disease in chondrodystrophoid breeds, evaluating patient status and identifying concurrent epidural hemorrhage.
Animals ; Dog Diseases/*pathology/radiography ; Dogs ; Intervertebral Disk Displacement/radiography/*veterinary ; Lumbar Vertebrae/*pathology/radiography ; Retrospective Studies ; Thoracic Vertebrae/*pathology/radiography ; Tomography, X-Ray Computed/methods/standards/*veterinary

The presence of a malignant mixed tumor, also known as a carcinosarcoma, in the salivary gland is very rare. Such mors, which are typically aggressive, are characterized by the presence of carcinomatous and sarcomatous components. 9-year-old neutered female domestic short-haired cat presented with swelling in the right mandibular lesion that had rapidly enlarged over the previous 3 weeks. Physical examination revealed a large, fluctuated and painless subcutaneous swelling that was associated with a firm mass. Radiographs of the head revealed a soft-tissue density that involved faint circular calcific opacity. Contrast-enhanced computed tomography revealed that the peripheral capsulated cystic area had a contrast enhanced region without bone lysis. The cat received a total excision of the mass and postoperative radiotherapy. Histopathological analysis of the mass revealed that it was a malignant mixed tumor. Metastasis to the lung was discovered 7 weeks later, at which time treatment was stopped.
Adenocarcinoma/pathology/surgery/*veterinary ; Animals ; Cat Diseases/*pathology/*radiography ; Cats ; Chondrosarcoma/pathology/surgery/*veterinary ; Fatal Outcome ; Female ; Lung/pathology/radiography ; Radiography, Thoracic/veterinary ; Salivary Gland Neoplasms/pathology/radiography/*veterinary

Tracheal ultrasonography was performed to measure the width of the tracheal ring shadow and to assess the clinical relevance of these measurements for identifying tracheal collapse. The first tracheal ring width (FTRW) and thoracic inlet tracheal ring width (TITRW) were measured on both expiration and inspiration. The mean of the FTRW width (129 dogs) was greater in expiration (10.97 +/- 1.02 mm, p = 0.001) than that in inspiration (9.86 +/- 1.03 mm). For 51 normal dogs, the mean of the TITRW width was greater in expiration (9.05 +/- 1.52 mm, p = 0.001) than in inspiration (8.02 +/- 1.43 mm). For 78 tracheal collapse dogs, the mean of the TITRW width was greater in expiration (15.89 +/- 1.01 mm, p = 0.001) than in inspiration (14.85 +/- 1.17 mm). The TITRW/FTRW ratio of the normal dogs was higher (p = 0.001) in expiration (0.81 +/- 0.09) than that in inspiration (0.79 +/- 0.10). When compared between the normal and tracheal collapse dogs, the TITRW/FTRW ratio was also increased (p = 0.001) both in expiration (1.54 +/- 0.09) and inspiration (1.47 +/- 0.08), respectively. Based on these results, the cutoff level of the TITRW/FTRW ratio was statistically analyzed according to the receiver operating characteristic curve and it could be set at 1.16 in expiration and at 1.13 in inspiration. We have demonstrated that tracheal ultrasonography is a useful technique for the evaluation of tracheal collapse and it can be a supportive tool together with the radiographic findings for making the correct diagnosis.
Animals ; Dog Diseases/diagnosis/pathology/*ultrasonography ; Dogs ; Female ; Male ; Radiography, Thoracic/*veterinary ; Sensitivity and Specificity ; Trachea/*pathology/radiography ; Tracheal Stenosis/diagnosis/pathology/veterinary

Percutaneous CT-guided needle biopsy of mediastinal and pulmonary lesions is a minimally invasive approach for obtaining tissue for histopathological examination. Although it is a widely accepted procedure with relatively few complications, precise planning and detailed knowledge of various aspects of the biopsy procedure is mandatory to avert complications. In this pictorial review, we reviewed important anatomical approaches, technical aspects of the procedure, and its associated complications.
Biopsy, Needle/instrumentation/*methods ; Contrast Media/diagnostic use ; Equipment Design ; Fluoroscopy ; Humans ; Lung Diseases/*pathology/radiography ; Mediastinal Diseases/*pathology/radiography ; Patient Positioning ; Radiography, Interventional/*methods ; Radiography, Thoracic/*methods ; *Tomography, X-Ray Computed

OBJECTIVE: We report magnetic resonance imaging (MRI) findings on focal anterior displacement of the thoracic spinal cord in asymptomatic patients without a spinal cord herniation or intradural mass. MATERIALS AND METHODS: We identified 12 patients (male:female = 6:6; mean age, 51.7; range, 15-83 years) between 2007 and 2011, with focal anterior displacement of the spinal cord and without evidence of an intradural mass or spinal cord herniation. Two radiologists retrospectively reviewed the MRI findings in consensus. RESULTS: An asymmetric spinal cord deformity with a focal dented appearance was seen on the posterior surface of the spinal cord in all patients, and it involved a length of 1 or 2 vertebral segments in the upper thoracic spine (thoracic vertebrae 1-6). Moreover, a focal widening of the posterior subarachnoid space was also observed in all cases. None of the patients had myelopathy symptoms, and they showed no focal T2-hyperintensity in the spinal cord with the exception of one patient. In addition, cerebrospinal fluid (CSF) flow artifacts were seen in the posterior subarachnoid space of the affected spinal cord level. Computed tomography myelography revealed preserved CSF flow in the two available patients. CONCLUSION: Focal anterior spinal cord indentation can be found in the upper thoracic level of asymptomatic patients without a spinal cord herniation or intradural mass.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cerebrospinal Fluid/physiology ; Female ; Hernia/pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Spinal Cord Diseases/pathology/*radiography/surgery ; Spine/pathology/radiography ; Thoracic Vertebrae/pathology/*radiography ; Tomography, X-Ray Computed ; Young Adult

Pneumoconiosis was diagnosed by open lung biopsy in two dental technicians who had interstitial lung disease. Mineralogical analysis was performed to investigate the origin of the dust that had been inhaled. A marked accumulation of silicon and phosphorus was found in both cases. The hard metals chromium and cobalt were also found. Dental technician's pneumoconiosis is a complex pneumoconiosis in which such dust and hard metals may play a role.
Adult ; *Dental Technicians ; Human ; Lung/pathology ; Lung Diseases, Interstitial/*diagnosis/metabolism ; Male ; Minerals/metabolism ; Occupational Diseases/*diagnosis/metabolism ; Pneumoconiosis/*diagnosis/metabolism ; Radiography, Thoracic ; Tomography, X-Ray Computed

Churg-Strauss syndrome (CSS), or allergic granulomatosis, is a rare disease manifested by tissue infiltration, hypereosinophilia and vasculitis. Renal involvement may be seen in up to 50% of cases. We report the case of a 25-year old man who presented with a history of fever for two months, tingling, numbness, and paraesthesia of the upper limbs and left lower limb, along with diarrhoea for one month and an inability to walk for the past seven days. Serial laboratory investigations helped to reach the final diagnosis of CSS with mononeuritis multiplex, and skin, pulmonary and gastrointestinal involvement with hypertension. This is due to renal involvement in the form of focal segmental glomerulosclerosis without any nephrotic range proteinuria, which is a very rare clinical entity. The patient's symptoms were relieved after the administration of an unconventional mode of therapy.
Adult ; Biopsy ; Churg-Strauss Syndrome ; complications ; diagnosis ; Fever ; Glomerulosclerosis, Focal Segmental ; complications ; diagnosis ; Humans ; Kidney ; pathology ; Kidney Diseases ; complications ; Male ; Proteinuria ; diagnosis ; Radiography, Thoracic ; Skin ; pathology ; Treatment Outcome

Cardiac enlargement is an important symptom of vascular and heart disease. The cardiothoracic ratio (CTR) is an important index used to measure the size of heart. The aim of this study was to assess the relationship between aging and cardiothoracic ratio. This paper also presents an improved C-V level set method to segment lung tissue based on X-ray image, which used to automatically compute CTR. In the investigation carried out in our school, we got more than 3 120 chest radiographs from medical examination of the working population in Beijing, and we systematically studied the effects of age and gender on the CTR to obtain reference values for each group. The reference values established in this study can be useful for recording and quantifying the cardiac enlargement, so that it may be useful for calling attention to the cardiovascular diseases and the heart diseases.
Aging ; Algorithms ; Cardiomegaly ; pathology ; Heart ; diagnostic imaging ; Heart Diseases ; diagnosis ; Humans ; Lung ; diagnostic imaging ; Myocardium ; pathology ; Radiography, Thoracic ; methods ; Reference Values