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Objective: The aim of the study was to evaluate the interstitial changes adjacent to pleural inflammation on multidetector computed tomography., Methods: The multidetector computed tomography scans of 30 patients with pleural inflammation were retrospectively and blindly evaluated by 2 observers. A control group of 7 patients with documented fibrothorax was also included. The number, appearance, thickness, and extent of septal lines were analyzed., Results: More than 10 septal lines immediately adjacent to the abnormal pleura were seen in 22 of the 30 patients with pleural inflammation and 2 of the 7 patients with fibrothorax (P<0.01). Septal lines that are more than 1 mm thick were seen in 13 of the 30 patients with acute inflammation and none of the patients with fibrothorax (P<0.01). Differences between focal and diffuse pleural inflammation included 10 cm or greater craniocaudal extent and more smooth septal lines with diffuse pleural inflammation., Conclusions: Pleural inflammation is associated with increased number and thickening of septal lines in the immediately adjacent lung parenchyma.

Objective: To assess the high-resolution computed tomography (HRCT) appearances of bronchiolitis obliterans organizing pneumonia (BOOP) after bone marrow transplantation (BMT)., Methods: The HRCT scans obtained in 4 patients (2 men and 2 women, age range: 20-50 years, mean age = 36 years) with biopsy-proven BOOP after BMT were reviewed retrospectively by 2 observers for the presence, extent, and distribution of parenchymal abnormalities., Results: All patients demonstrated consolidation and ground-glass opacity. The consolidation was bilateral, patchy, and asymmetric in all patients and was predominantly peribronchovascular in 3 patients and subpleural and peribronchovascular in 1 patient. Ground-glass opacity was patchy and asymmetric in all patients and was bilateral in 3 patients and unilateral in 1 patient. No zonal predominance of either feature could be identified., Conclusions: The predominant HRCT features of BOOP after BMT are bilateral, patchy, and asymmetric consolidation in a predominantly peribronchovascular distribution with associated ground-glass opacity.

Objective: To determine the prognostic value of thin-section computed tomography (CT) findings in patients with mucin-producing adenocarcinoma (MPA) of the lung., Methods: The study included 48 patients with pathologically proven MPA who had thin-section CT before treatment. The CT findings were correlated with the histopathologic findings and with disease-free survival on follow-up in all patients., Results: Computed tomography findings identified in patients with MPA of the lung included an air bronchogram (n = 37, 77.1%), areas of ground-glass attenuation (n = 36, 75.0%), areas of air-space consolidation (n = 36, 75.0%), interlobular septal thickening (n = 33, 68.8%), bubble-like lucencies (n = 23, 47.9%), centrilobular nodules (n = 22, 45.8%), and mucus filling of airways (n = 19, 39.6%). Twenty-two (45.8%) of the 48 patients had intrapulmonary metastases. Centrilobular nodules (odds ratio [OR] = 6.7, 95% confidence interval: 1.1-41.4; P < 0.05) and mucus filling of airways (OR = 14.4, 95% 95% confidence interval: 2.0-102.7; P < 0.01) on thin-section CT were independently associated with an increased likelihood of intrapulmonary metastases. The 5-year disease-free survival rates were 67.9% and 38.4% for patients without and with intrapulmonary metastases, respectively (P < 0.05). The presence of centrilobular nodules (relative risk = 10.5, 95% confidence interval: 1.8-59.3; P < 0.01) on thin-section CT was an independent predictor of poor prognosis., Conclusion: Centrilobular nodules on CT are associated with a higher prevalence of intrapulmonary metastases and a poor prognosis in patients with MPA of the lung.

Objective: To assess high-resolution computed tomography (HRCT) findings in silicosis and to better define the role of HRCT in early detection of parenchymal abnormalities in silica-exposed workers., Methods: Forty-one stone carvers were evaluated with chest radiographs (CR), HRCT, and pulmonary function tests (PFT). Inter-reader agreement was calculated using the kappa statistic (k). Correlation between radiographic and HRCT profusion scores and PFT was assessed using the Spearman correlation coefficient., Results: The most common HRCT findings were branching centrilobular structures, seen in 28/41 workers (68.3%). Nodules consistent with silicosis were detected in 53.7% workers on CR and in 56.1% workers on HRCT. Inter-reader agreement for diagnosis of silicosis was better on HRCT (k = 0.84) than on CR (k = 0.54). Small opacity profusion on HRCT correlated inversely with total lung capacity and FVC%., Conclusion: Profusion of opacities on HRCT correlates with functional impairment. The presence of branching centrilobular structures may be helpful in early recognition of silicosis.

Objective: To assess the characteristic features of the primary mediastinal lymphoma (PML) on CT and to test the relationship between CT findings and the likelihood of the 3 most common subtypes (Hodgkin lymphoma [HL], mediastinal diffuse large B-cell lymphoma [Med-DLBCL], and precursor T-cell lymphoblastic lymphoma [T-LBL])., Methods: Sixty-six consecutive patients with pathologically proven PML including 29 patients with HL, 21 with Med-DLBCL, and 16 with T-LBL underwent CT prior to therapy. CT scans were independently reviewed by 2 radiologists who were blinded to the pathologic diagnosis for the following considerations: pattern of involvement (i.e., morphologic features, mass size, and contrast enhancement pattern), and ancillary findings at other sites including neck, abdomen, and pelvis. Interobserver agreement was measured by Kappa statistics, and independent predictors were calculated using multiple logistic regression analysis for determining the likelihood of the subtypes based on CT., Results: Characteristic features of HL included irregular contour of the anterior mediastinal mass (20 of 29, 69%) and high prevalence of associated mediastinal lymphadenopathy (28 of 29, 97%). Characteristic features of Med-DLBCL included regular contour (14 of 21, 67%) and absence of cervical and abdominal lymphadenopathy (0 of 21). Characteristic features of T-LBL included regular contour (12 of 16, 75%) and high prevalence of cervical (9 of 16, 56%) and abdominal (6 of 16, 38%) lymphadenopathy and splenomegaly (11 of 16, 69%). CT findings independently associated with increased likelihood of HL were surface lobulation (P <0.01), the absence of vascular involvement (P <0.01), or pleural effusion (P <0.05). The presence of vascular involvement was associated with increased likelihood of Med-DLBCL (P <0.001). Furthermore, CT findings including the presence of cervical lymph nodes or inguinal lymph nodes (P <0.001), the presence of pericardial effusion (P <0.05), and the absence of surface lobulation (P <0.05) were significantly associated with the likelihood of T-LBL., Conclusion: The various histologic subtypes of PML have characteristic manifestations in the neck, chest, and abdomen, which allow their distinction on CT.

A case of tracheobronchopathia osteochondroplastica in a patient with silicosis is reported, showing a rare association of disease. Etiological hypotheses and clinical aspects are discussed. Radiologic, bronchoscopic, and pathologic findings are demonstrated with emphasis on the role of computed tomography (CT) in the diagnosis of this disease.

Objective: The purpose of this study was to assess the high-resolution computed tomography (CT) findings of familial idiopathic pulmonary fibrosis (IPF)., Methods: High-resolution CT scans obtained in 9 consecutive patients with biopsy-proven familial IPF were reviewed. The presence, distribution, and extent of various CT findings were evaluated., Results: All 9 patients had ground-glass opacities, intralobular reticular opacities, and irregular thickening of the interlobular septa; 7 (78%) had traction bronchiectasis, 7 (78%) had small foci of consolidation; and 3 (33%) had honeycombing. The abnormalities involved mainly the lower lung zones in 6 patients and the upper lung zones in 2 patients and had no zonal predominance in 1 patient. Follow-up CT showed increased extent of disease in 8 patients., Conclusions: The high-resolution CT findings of familial IPF resemble those of nonfamilial IPF. Familial IPF has a lower prevalence of honeycombing and a lower prevalence of predominant lower lung zone distribution than nonfamilial IPF, however.

Niemann-Pick disease is a rare inherited disorder characterized by deposition of sphingomyelin in various organs. We describe the high-resolution computed tomography findings in 2 adult sisters with Niemann-Pick disease and extensive pulmonary involvement. The main abnormalities consisted of thickening of the interlobular septa and patchy areas of ground-glass attenuation.