대한흉부영상의학회 Korean Society of Thoracic Radiology

대한흉부영상의학회 Weekly Case 메뉴

Close

대한흉부영상의학회 Weekly Case 검색
대한흉부영상의학회 Weekly Case 검색
Advanced Search..

Close

Weekly Chest CasesArchive of Old Cases

Case No : 918 Date 2015-06-01

  • Courtesy of Sung Shine Shim, Yookyung Kim / Mokdong Hospital Ewha Womans University
  • Age/Sex 44 / M
  • Chief ComplaintHemoptysis. Past history of internal fixation of spines 14 years ago
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5
  • Figure 6

Diagnosis With Brief Discussion

Diagnosis
Pulmonary involvement in ankylosing spondylitis
Radiologic Findings
3. Chest simple radiographs and CT scans show bullous cystic changes with multiple extensive fibrosis in both lungs, especially in the upper lobes with fungal balls in bullous emphysema. “Squaring’ of thoracolumbar vertebrae, together with syndesmophytes and ossified ligaments are noted on lateral view of the chest simple radiograph. These bony lesions of the patient were diagnosed as ankylosing spondylitis 16 years ago. In the mediastinal setting of the CT scan seen below, hypertrophied bronchial arteries can be seen.
Brief Review
5. High-resolution computed tomography (HRCT) abnormalities are prevalent (range, 50-85%) in ankylosing spondylitis (AS) even in patients with early disease and in those with normal chest radiographs without respiratory symptoms. The most common abnormal thoracic radiological findings of AS include apical fibrosis, emphysema, pleural involvement, nonspecific linear parenchymal opacities, lymphadenopathy, bronchiectasis, bronchial wall thickening, tracheal dilatation, mosaic patterns, sub-pleural nodules and interstitial lung disease. In general, HRCT changes are of mild degree, and no correlation has thus far been observed between HRCT findings, PFT variables and indices of ankylosing spondylitis symptoms and disease structural severity.
References
Quismorio FP Jr. Pulmonary involvement in ankylosing spondylitis. Curr Opin Pulm Med. 2006;12:342-345
2. Sampaio-Barros PD, Cerqueira EM, Rezende SM, et al. Pulmonary involvement in ankylosing spondylitis. Clin Rheumatol. 2007;26:225–230.
3. Kiris A, Ozgocmen S, Kocakoc E, et al. Lung findings on high resolution CT in early ankylosing spondylitis. Eur J Radiol. 2003;47:71–76.
Keywords
Lung, Vertebra, Non-infectious inflammation,

No. of Applicants : 93

▶ Correct Answer : 39/93,  41.9%
  • - university of montreal , Canada Andrei Gorgos I
  • - The University of Tokyo Hospital , Japan Takeyuki Watadani
  • - Goa Medical College , India Paresh Desai
  • - The University of Tokyo Hospital , Japan Toshihiro Furuta
  • - 異⑸ , Korea (South) Yunhee Jang
  • - University of British Columbia , Canada Amr Ajlan
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - Saket City Hospital , India Rajesh Gothi
  • - Ajou University hospital , Korea (South) Hun Cho
  • - DELTA CARE HOSPITAL, THANJAVUR, INDIA , India SIVARAJA SUBRAMANIAM
  • - DAYA General Hospital,Thrissur,Kerala , India Raveendran TK
  • - McGill University Health Center , Canada Alexandre Semionov
  • - Northern Yokohama Showa university , Japan Kota Watanabe
  • - Wuhan Union Hospital , China Qiguang Cheng
  • - GHICL , France manuel toledano
  • - SMG - SNU Boramae Medical Center , Korea (South) Ye Ra Choi
  • - Niigata City General Hospital , Japan Takao Kiguchi
  • - Myongji hospital , Korea (South) Ji Ye Lee
  • - Asan Medical Center , Korea (South) Soyeoun Lim
  • - Asan , Korea (South) Sania ALBlushi
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - Asan Medical Center , Korea (South) Hyung Jung Koo
  • - Pusan national university hospital , Korea (South) Hie Bum Suh
  • - Fortis hospital , Mohali , India Shaleen Rana
  • - Yokohama-asahi-chuo-general hospital , Japan Kyoko Nagai
  • - VHS medical center , Korea (South) Keuntak Roh
  • - McGill University / University College London , Canada Ilan Azuelos
  • - Nasaret Hospital , Korea (South) Hee Seok Choi
  • - chungbuk national university hospital , Korea (South) soojung lee
  • - Myoungji hospital , Korea (South) Dae Woong Park
  • - chungbuk university hospital , Korea (South) Hyeonmi Ryu
  • - PNUH , Korea (South) Seungbaek Hong
  • - 遺€ , Korea (South) LEE YOU JIN
  • - National Center hospital of Neurology and Psychiatry , Japan Kaoru Sumida
  • - Seirei Hamamatsu General Hospital , Japan Kenichi Mizuki
  • - Pneumologia Universitaria, Policlinico di Bari , Italy Mario Damiani
  • - ZIGONG TCM HOSPITAL OF CHINA , China Cao Cunyou
  • - 異⑸ , Korea (South) Junghwan Kim
  • - Santosh hospital,Bengaluru , India Pravin Mahadevappa
▶ Correct Answer as Differential Diagnosis : 4/93,  4.3%
  • - Juntendo University Hospital , Japan Akifumi Hagiwara
  • - Pusan national university hospital , Korea (South) So Park
  • - jaslok hospital & research centre mumbai , India JAINENDRA JAIN
  • - Gifu Central Hospital , Japan Haruo Watanabe
  • Top
  • Back

Each Case of This Site Supplied by the Members of KSTR.
Copyright of the Images is in the KSTR and Original Supplier.
Current Editor : Sang Young Oh, M.D., Ph.D Email : sangyoung.oh@gmail.com

This website is optimized for IE 10 and above.