대한흉부영상의학회 Weekly Chest Cases

Courtesy of Tae Sung Kim, MD / Kyung Soo Lee, MD, Samsung Medical Center, Seoul, Korea
Age/Sex 34 / F
Chief ComplaintFever on the 50th day after bone marrow transplantation for AML (acute myelogenous leukemia)

CT1

Diagnosis: CMV (cytomegalovirus) pneumonia
Radiologic Findings: HRCT Findings
Diffuse and multifocal areas of ground-glass attenuation are seen in both lungs. Patchy nodular opacities and septal line thickening are also noted.
Discussion
Cytomegalovirus (CMV) is recognized as the most common viral pathogen to cause substantial morbidity and mortality in patients with marrow transplantation. Patients with CMV pneumonia may have nonproductive cough, dyspnea, hypoxemia, or fever, with a median onset of 60 days after marrow transplant. Onset within the first two weeks is unusual. The period of risk of CMV pneumonia generally ends by approximately the fourth or fifth month after transplant. Chest radiograph generally shows bilateral infiltrates; in later stages, diffuse consolidation occurs. Unilateral, focal, and even nodular infiltrates have been seen in the early stages. CT findings include ground-glass attenuation, dense consolidation, bronchial wall thickening or bronchiectasis, discrete pulmonary nodules or masses, and interstitial reticulation without air-space disease.
Brief Review
References: McGuinness G, Scholes JV, Garay SM, Leitman BS, McCauley DI, Naidich DP. Cytomegalovirus pneumonitis: spectrum of parenchymal CT findings with pathologic correlation in 21 AIDS patients. Radiology 1994;192:451-459
Keywords: Lung, Infection, Viral infection,

대한흉부영상의학회 Korean Society of Thoracic Radiology