대한흉부영상의학회 Weekly Chest Cases

Case No : 609 Date 2009-06-28

Courtesy of Joo Sung Sun, Kyung Joo Park / Ajou University School of Medicine
Age/Sex 59 / F
Chief ComplaintLow grade fever for 1 week and sputum for 2 weeks

Figure 1
Figure 2
Figure 3

Diagnosis With Brief Discussion

Diagnosis: Unilateral BOOP(COP)
Radiologic Findings: Figs 1. Chest PA shows patchy increased opacity looks like ground glass opacity at Lt mid and lower lung zone.

Fig 2-3. Localized ground glass opacities with interstitial thickening are noted at LUL lingular segment and LLL basal segment on lung window setting images.
Mediastinal window images show several enlarged lymph nodes of mediastinum and hilum.
Brief Review: Three major radiographic patterns in patients with BOOP were reported. Multiple sites of patchy pulmonary involvement of the pneumonia type localized pulmonary involvement manifesting as focal consolidation or solitary nodule or mass, diffuse peripheral subpleural type.
Boop traditionally presents as a bilateral pulmonary disease. Unilateral BOOP is interesting and should be differentiated from unilateral pulmonary disease including neoplasm such as BAC or BALTOMA. Therefore, it is important to obtain a lung biopsy for confirmation
References: 1.Bartter T, Irwin RS, Nash G, Balikian JP, Hollingsworth HH. Idiopathic bronchiolitis obliterans organizing pneumonia with peripheral infiltrates on chest roentgenogram. Arch Intern Med 1989; 149: 273-279.
2.Kanwar BA, Shehan CJ, Campbell JC, Dewan N, O묭onohue WJ Jr. A case of unilateral bronchiolitis obliterans organizing pneumonia (BOOP). Nebraska Medical Journal 1996; 81: 149-151.
3.Lombard C, Yousem SA, Kitaichi M, Colby TV, editors. Atlas of pulmonary surgical pathology. Philadelphia: W.B. Saunders Company; 1991:356?9.
Keywords: Lung, Idiopathic interstitial pneumonia, IIP,

No. of Applicants : 79

▶ Correct Answer : 7/79, 8.9%

- Institute of Chest Diseases,Calicut , India sijith raghavan
- DR.D.Y. PATIL MEDICAL COLLEGE , NAVI MUMBAI. , India girish verma
- Vital Imaging Centre, Mumbai,India , India Ganesh Agrawal
- Seoul National University Hospital , Korea (South) Hye Jin Yoo
- Father Muller Medical College , Mangalore , India nabil mahmood
- Pusan National University Hospital , Korea (South) YU LI SOL
- mediciti hospitals , India paramjyothi gongati

▶ Correct Answer as Differential Diagnosis : 22/79, 27.8%

- POPOVO HOSPITAL , Bulgaria VLADISLAV RUSINOV
- PingTung Christian Hospital ,China Medical University ,Taiwan,R.O.C. , Taiwan Jun Jun Yeh
- Chaeil Clinic , Korea (South) Sunkyung Lim
- jaslok hospital & research centre mumbai , India JAINENDRA JAIN
- Kangnam Sacred Heart Hospital , Korea (South) Jaewon Kim
- SAISEIKAI KURIHASHI HOSPITAL , Japan YASUO OKUBO
- Shinsegye Rad Clinic, Daegu , Korea (South) Gi Beom Kim
- Hospital M de Deus , Brazil Thiago Bento da Silva
- IRSA La Rochelle France , France Denis Chabassiere
- The Armed Forces Daegu Hospital , Korea (South) Hyungwoo Oh
- All India Institute of medical sciences , India Justin Moses
- Hopital du SacrCoeur , Canada Abraham Bohadana
- Homs National Hospital , Syria Rami Abou Zalaf
- Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
- CHUV, Lausanne , Switzerland Andrea Ojanguren
- Hospital Sotiria, Athens, Greece , Greece Vasilios Tzilas
- clinique de SAVOIE , France, Metropolitan gay-depassier philippe
- Seoul Nationial University Bundang Hospital , Korea (South) Hee Seok Choi
- Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
- Saga University , Japan Ryoko Egashira
- Mallinckrodt Institute of Radiology , United States Naganathan Mani
- kims,narkatpally , India k bhaskar

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 609 Date 2009-06-28

Discussion

No. of Applicants : 79