대한흉부영상의학회 Korean Society of Thoracic Radiology

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Weekly Chest CasesCases by Disease Category

Case No : 1252 Date 2021-10-18

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  • Courtesy of Hye Soo Cho, Jin Young Yoo, Sung Jin Kim / Chungbuk National University Hospital
  • Age/Sex 37 / F
  • Chief ComplaintRash and chest wall pain for 2 weeks
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5
  • Figure 6
  • Figure 7
  • Figure 8

Diagnosis With Brief Discussion

Diagnosis
SLE pleuritis/pleurisy
Radiologic Findings
Fig 1. Chest PA shows left pleural effusion.
Fig 2-7. Chest CT scans reveal subtle high density bilateral pleural effusion with pleural thickening and pericardial effusion. There are focal enhancing dot-like lesions in pleural effusion and pericardial effusion
Fig 8. [3 years ago] Chest CT scan shows bilateral pleural effusion and a small amount of pericardial effusion with mild pericardial thickening.
Brief Review
Systemic lupus erythematosus (SLE) is an autoimmune disorder characterized by inflammation, immune complex deposition, vasculitis, and vasculopathy. Involvement of the respiratory system in SLE is relatively common. SLE can affect the pleura, lung, and respiratory muscles, all contributing to respiratory dysfunction.
Pleural effusions are the most common manifestation of SLE in the respiratory system and are bilateral in approximately 50% of patients. Pleural effusions in SLE are generally small and are exudative, containing lupus erythematosus cells, immune complexes, and anti-DNA antibodies, among other things. Pleuritis and pleural fibrosis are reported in 50%
References
1. Tasneem A. Lalani, Jeffrey P. Kanne, Gregory A. Hatfield, Phebe Chen. Imaging Findings in Systemic Lupus Erythematosus. RadioGraphics 2004; 24:1069-1086.
2. Kim JS, Lee KS, Koh E, Kim SY, Chung MP, Han J. Thoracic Involvement of Systemic Lupus Erythematosus: Clinical, Pathologic, and Radiologic Findings. J Comput Assist Tomogr.2000 Jan-Feb;24(1):9
Keywords

No. of Applicants : 81

▶ Correct Answer : 40/81,  49.4%
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Korea University Guro Hospital , Korea (South) SEOKYOUNG LEE
  • - , Japan JUN KANZAWA
  • - Chungbuk National University Hospital , Korea (South) YEONGTAE PARK
  • - Other , Korea (South) HYEJIN YANG
  • - Dhq hospital faisalabad , Pakistan AMMAR AHMED
  • - , Korea (South) HYEYOUNG CHOI
  • - , United Kingdom SAMSON KADE
  • - Other , Korea (South) MINGI SHIN
  • - CHCB , France LE GUEN RAPHAEL
  • - Osaka Red Cross Hospital , Japan YUSUKE UTSUNOMIYA
  • - , Italy PAOLO BALDASSARI
  • - Other , Korea (South) SEONGSU KANG
  • - Scans world , India PHILSON JOSEPH MUKKADA
  • - Shimada General Medical Center , Japan HAYATO NOZAWA
  • - National Center for Global Health and Medicine , Japan MASATOSHI HOTTA
  • - , Korea (South) HYEWON CHOI
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Seoul National University Bundang Hospital , Korea (South) SUNG HYUN YOON
  • - Yeungnam University Medical Center , Korea (South) JONGSOO PARK
  • - Gifu University Hospital , Japan Yo Kaneko
  • - McGill , Canada MUTAZ ADNAN KHAIRO
  • - , Korea (South) EUNJIN LEE
  • - Other , Korea (South) SEUNGHYUN LIM
  • - Chungbuk National University Hospital , Korea (South) MIHYEON PARK
  • - Other , Korea (South) MINSU KIM
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - Avrasya Hospital/ISTANBUL , Turkey MURAT ULUSOY
  • - Seoul Veterans Hospital , Korea (South) SEONG WON JANG
  • - Dokkyo Medical University , Japan HIROAKI ARAKAWA
  • - Chungbuk National University Hospital , Korea (South) PARK JUN HYEON
  • - Kyoto University Hospital , Japan SATOSHI IKEDA
  • - Nishida Hospital , Japan SHOJI OKUDA
  • - University of Tsukuba Hospital , Japan SODAI HOSHIAI
  • - The University of Tokyo Hospital , Japan HIROSHI TAKUMIDA
  • - Chonnam National University Hospital , Korea (South) SEUNG WAN KANG
  • - , Japan YUKI HAYASHI
  • - , Korea (South) WONJU HONG
  • - , Korea (South) JIHYUN KIM
  • - Korea University Guro Hospital , Korea (South) HWANSEOK YONG
▶ Correct Answer as Differential Diagnosis : 15/81,  18.5%
  • - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
  • - McGill University Health Center , Canada ALEXANDRE SEMIONOV
  • - Tiger Gate Hospital , Japan SHIN-ICHI CHO
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Osaka University , Japan AKINORI HATA
  • - Kyoto University Hospital , Japan YASUHISA KURATA
  • - Mallinckrodt Institute of Radiology , United States NAGANATHAN MANI
  • - Osmania Medical College, Hyderabad , India PURUSHOTHAMA RAO TUMMALA
  • - Other , Korea (South) KYU-CHONG LEE
  • - Toranomon Hospital , Japan KAORU SUMIDA
  • - Chonbuk National University Hospital , Korea (South) DONG HAN SHIN
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - Diagnose.me (BV) / Royal Perth Hospital , Australia YURANGA WEERAKKODY
  • - Hanyang University Hospital , Korea (South) SEUNG JIN YOO
  • - Jiangsu province hospital , China WANGJIAN ZHA
▶ Semi-Correct Answer : 3/81,  3.7%
  • - , Japan CHIAKI SATO
  • - HHS , Canada S LEE
  • - National Research Cardiac Surgery Center of Kazakhstan , Kazakhstan ZHOLAMAN NURLANOV NURLANOVICH
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