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Weekly Chest CasesArchive of Old Cases

Case No : 653 Date 2010-05-03

  • Courtesy of Yon Mi Sung / Gil Hospital, Gachon University of Medicine and Science
  • Age/Sex 31 / M
  • Chief ComplaintChronic cough and sputum
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4

Diagnosis With Brief Discussion

Diagnosis
Cystic Fibrosis
Radiologic Findings
CT of the thorax on lung window setting reveals extensive bilateral bronchiectasis with bronchial wall thickening and areas of decreased attenuation and vascularity. CT of the abdomen shows near total fatty replacement of the pancreas.
Brief Review
Cystic fibrosis is an autosomal recessive hereditary disease and uncommon in nonwhites. The basic abnormality consists of abnormal secretions from various exocrine glands including the salivary and sweat glands, pancreas, large bowel and tracheobronchial tree. The major clinical manifestations are obstructive pulmonary disease, which is found in varying degree of severity in almost all patients, and pancreatic insufficiency.
The main CT manifestation of cystic fibrosis is bronchiectasis, which is present in virtually all adult patients. Bronchiectasis usually involves all lobes, but tends to be most severe in the upper lobes.
In patients with cystic fibrosis, pancreatic glandular tissue is significantly reduced in size. Pancreatic fatty replacement is the most frequent pattern in older patients with cystic fibrosis.
References
1. Muller NL, Silva CS. Imaging of the Chest. Saunders 2008:1039-1044
2. Soyer P, Spelle L, Pelage JP, et al. Cystic Fibrosis in Adolescents and Adults: Fatty Replacement of the Pancreas - CT Evaluation and Functional Correlation. Radiology 1999:210;611-615
Keywords
Airway, Congenital,

No. of Applicants : 125

▶ Correct Answer : 96/125,  76.8%
  • - Hotel-Dieu Montreal , Canada nicolas gautier
  • - Song-do Hospital , Korea (South) Ji-young Yun
  • - University of British Columbia , Canada Amr Ajlan
  • - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
  • - Hangang sacred heart hospital , Korea (South) You Mie Han
  • - Youngdong Hospital , Korea (South) Sang Min Lee
  • - Yashoda Superspeciality hospital , India Pravin Mahadevappa
  • - Father Muller Medical College , Mangalore , India nabil mahmood
  • - NOUR EL-ISLAM RADIOLOGY CENTER , Egypt Elsayed Mousa
  • - IRCCS Istituto Oncologico - Bari , Italy Carlo Florio
  • - Doctors Hospital , Bahamas muneesh sharma
  • - Vitalife Clinics , Pune , India. , India Rahul Deshmukh
  • - Uzunkopru Devlet Hastanesi , Turkey Armagan Sarac
  • - CHUV , Switzerland ANNE-SOPHIE KNOEPFLI
  • - Univ. of Miami/Jackson Memorial , United States mantosh rattan
  • - Osaka University , Japan Osamu Honda
  • - CH Sud Rnion , Reunion jean-baptiste Noel
  • - KING KHALID UNIVERSITY HOSPITAL , Saudi Arabia Elbagir Nasser
  • - Nonsan Hospital , Korea (South) Eun-Tae Park
  • - hospital de clinicas de porto alegre , Brazil ana zanardo
  • - McGill University , Canada Ben Smith
  • - Goa Medical College , India Paresh Desai
  • - Department of Diagnostic Radiology, Chonbuk National University Hospital , Korea (South) Eun Jung Choi
  • - CHU Nancy , France, Metropolitan Guillaume LUX
  • - seoul national university hospital , Korea (South) Ijin Joo
  • - Ondokuz Mayis University , Turkey Cetin Celenk
  • - UZ GASTHUISBERG , Belgium Johan COOLEN
  • - Vital Imaging Centre, Mumbai,India , India Ganesh Agrawal
  • - CHU NANCY , France, Metropolitan GREGORY LESANNE
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - Doctors Hospital , Bahamas Sankar Mondal
  • - Hospital M de Deus , Brazil Thiago Bento da Silva
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - chonnam national university , Korea (South) Byung Hyun Baek
  • - Seoul Veterans Hospital , Korea (South) Hye Sun Hwang
  • - EKH-Berlin , Germany Michael Weber
  • - Toyama University Hospital, Laboratory of Pathology , Japan TOMONORI TANAKA
  • - CHRU lille , France manuel toledano
  • - Kwang Myung Sungae Hospital , Korea (South) Jiyong Rhee
  • - Inha University Hospital , Korea (South) Ju Won Lee
  • - Teleradiology solutions , India harish bhambore
  • - CHU BRABOIS , France S. APTEL - A. RAYMOND - NANCY
  • - EWHA WOMANS MOKDONG UNIVERSITY HOSPITAL , Korea (South) YOOKYUNG KIM
  • - EWHA WOMANS MOKDONG UNIVERSITY HOSPITAL , Korea (South) Sang Min Lee
  • - Seoul St. Mary hospital , Korea (North) gyungeun Lee
  • - care hospital , India Chary D
  • - jaslok hospital & research centre mumbai , India JAINENDRA JAIN
  • - Bundang CHA hospital , Korea (South) Jung Jin Young
  • - Consultant Radiologist, London , United Kingdom Shekhar Banavali
  • - Beaulieu clinic Geneva , Switzerland gilles GENIN
  • - Yonsei university Shinchon Severance hospital , Korea (South) Na-young Shin
  • - McGill University Health Center , Canada Alexandre Semionov
  • - Chonnam university hospital , Korea (South) Minyoung Jung
  • - Chonnam national university hosipital , Korea (South) Byung chan Lee
  • - CHU Grenoble , France Fabrice Bing
  • - SUT Hospital , India Hari Krishnan
  • - IRSA La Rochelle France , France Denis Chabassiere
  • - HOSPITAL SOTIRIA , Greece AIKATERINI DELAVERI
  • - royal melbourne hospital , Australia stefan heinze
  • - PingTung Christian Hospital ,China Medical University ,Taiwan,R.O.C. , Taiwan Jun Jun Yeh
  • - IRSA , France jean-luc BIGOT
  • - Nirman hitech diagnostic centre , India minal seth
  • - HCG-MEDISURGE HOSPITAL , India PRAKASH ODEDRA
  • - KMC,Manipal , India satish maddukuri
  • - medical , India anup kumar
  • - Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
  • - SoonChunHyang univ. hospital , Korea (South) Kim Jae Hyun
  • - ROK air force aerospacemedical center , Korea (South) Daekeon Lim
  • - Samsung Medical Center , Korea (South) Jung Min Seo
  • - Seoul Nationial University Bundang Hospital , Korea (South) Hee Seok Choi
  • - kyungpook national university hospital , Korea (South) jiwon park
  • - Myongi , Korea (North) soon Moon
  • - SNUH , Korea (South) Sung Ui Shin
  • - Hangang Sacred Heart Hospital , Korea (South) Eil Seong Lee
  • - Department of Radiology, Chonnam National University Hospital , Korea (South) Hyungjun Kim
  • - clinique de SAVOIE , France, Metropolitan gay-depassier philippe
  • - All India Institute of Medical Sciences , India Ashish Gupta
  • - Mallinckrodt Institute of Radiology , United States Naganathan Mani
  • - Hospital Sotiria, Athens, Greece , Greece Vasilios Tzilas
  • - universidad de chile , Chile enrique aguilera
  • - NASA SCANS , India RAKESH BHATIA
  • - Saga University , Japan Ryoko Egashira
  • - PITTWATER RADIOLOGY , Australia Saurabh Khandelwal
  • - PITTWATER RADIOLOGY , Australia Julie Arora
  • - Chonnam National University , Korea (South) se hee Jung
  • - All India Institute of medical sciences , India Justin Moses
  • - Chonnam National University Hwasoon Hospiral , Korea (South) You Ri Choi
  • - CNUH , Korea (South) Hyedoo Jung
  • - Chonnam National University Hospital , Korea (South) Daun Lee
  • - Trakya University School of Medicine , Turkey Umut Ugur
  • - Chonnam National University Hospital , Korea (South) Jun Hyung Hong
  • - CNUH , Korea (South) Seoin Jeong
  • - Apollo Gleneagles hosp kolkata , India SALIM PARVEZ
  • - Chonnam national university hospital , Korea (South) SeungJin Lee
  • - Chungnam national university hospital , Korea (South) Jeoung Eun Lee
  • - Chonnam National University Hospital , Korea (South) Jung Kim
▶ Correct Answer as Differential Diagnosis : 9/125,  7.2%
  • - radiologist, aditya imaging centre , India vivek patel
  • - Yonsei University College of Medicine, Shinchon Severance hospital , Korea (South) Young Joo Suh
  • - kovai medical centre , India k bhaskar
  • - NDMVP Nashik , India Imran Jindani
  • - Radnet Teleradiology , Turkey Murat Ulusoy
  • - IRSA Rochefort , France Viviane Pages
  • - Hospital Moinhos de Ventos , Brazil Felipe Hertz
  • - chonnam university hospital , Korea (South) shin hyun
  • - Armed Forces Chun-Cheon Hospital , Korea (South) Chaehun Lim
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