대한흉부영상의학회 Weekly Chest Cases

Case No : 131 Date 2000-04-29

Courtesy of Duk-Sik Kang. M.D. / Kyungpook National University Hospital, Taegu, Korea
Age/Sex 59 / M
Chief ComplaintMild dysphagia and aggravating dyspnea for one month.

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Diagnosis With Brief Discussion

Diagnosis: Scleroderma with pulmonary involvement
Radiologic Findings: HRCT scan at the level of aortic arch shows mediastinal adenopathy. At ventricular level, dilated esophagus, moderate amount of pericardial effusion and pleural effusion are seen. Irregular interlobular septal thickening, subpleural honeycombing and traction bronchiectasis are predominant parenchymal changes.

Multiple bony erosion and joints involvement of hands were also seen.
Esophageal dilatation and aperistalsis were noted at barium study.
Brief Review: Scleroderma is a systemic collagen vascular disease of unknown cause characterized by vascular and connective tissue abnormalities. At autopsy, the lung are reportedly involved in 100% of cases of scleroderma and that is a major cause of death. HRCT findings of scleroderma are similar to those of IPF including ground-glass opacities, septal lines, traction bronchiectasis and honeycombing. Lymphadenopathy is prevalent. Enlargement of cardiac silhouette and pulmonary artery due to scleroderma induced pulmonary vascular disease also could be seen.
Observation of esophageal dilatation may help in narrowing the differential diagnosis in patients who have diffuse interstitial lung disease.
References: 1. Arroliga AC, Podell DN, Matthay RA. Pulmonary manifestation of scleroderma. J Thoracic Imaging, 1992, 7(2):30-45.
2. Wechsler RJ, Steiner RM, Spirn PW, et al. The relationship of thoracic lymphadenopathy to pulmonary interstitial disease in diffuse and limited systemic sclerosis: CT findings. AJR, 1996, 167(1):101-4.
3. Bhalla M, Silver, RM, Shepard, JA, McLoud TC, Chest CT in patients with scleroderma: prevalence of asymptomatic esophageal dilatation and mediastinal lymphadenopathy. AJR, 1993, 161(2):269-72.
Keywords: Lung, Connective tissue diseases, Systemic sclerosis,

No. of Applicants : 49

▶ Correct Answer : 41/49, 83.7%

- 媛泥
- 怨
- 怨媛李쏀
- 怨源
- 怨
- 怨
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- 留臾멸린
- 遺二쇱
- 遺
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- 源寃쎈
- 諛李쎈
- 源
- 理
- 源誘쇱
- 源
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- 蹂以
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- 諛
- 沅
- 以
- 以
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- 源
- 諛二쇱
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- 源
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- 源誘쇱
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- Dr. Jankharia's Imaging Centre Bhavin Jankharia
- Gachon Medical School Gil Medical Center Seo Joon Beom
- Hospital de Guipuzcoa San Sebastian Spain Gonzalo Vega - Hazas Porrua
- Samsung Medical Center Kyung Soo Lee
- Stedelijk OLV Ziekenhuis Mechelen, Belgium Ivan Pilate

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 131 Date 2000-04-29

Discussion

No. of Applicants : 49