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Weekly Chest CasesArchive of Old Cases

Case No : 947 Date 2015-12-21

  • Courtesy of Yoon Kyung Kim, Yon Mi Sung, Eun Young Kim / Gachon University Gil Medical Center
  • Age/Sex 24 / M
  • Chief ComplaintAbdominal pain
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5

Diagnosis With Brief Discussion

Diagnosis
Behcet’s disease
Radiologic Findings
Contrast enhanced chest CT and coronary CT angiography shows focal aneurysmal dilatation of the ascending aorta, origin of left subclavian artery, abdominal aorta, and the left anterior descending coronary artery. Irregular dilatation and thrombosis in left main pulmonary artery is also seen.
The patient has history of recurrent oral ulcer and genital ulcer, enthesitis in both heels, and erythematous skin lesions on his back and neck area for several years.
Brief Review
Behcet’ disease (BD) is a chronic systemic vasculitis characterized by recurrent oral and genital ulcer and uveitis. Thoracic involvement is seen up to 8% of the patients. BD is the most common cause of pulmonary artery aneurysm. CT chest may demonstrate a saccular or fusiform pulmonary artery aneurysm. Additionally, thrombosis, mosaic perfusion, pulmonary infarction and hemorrhage may also be seen. Diagnosis of BD requires recurrent oral ulceration plus any of the two of recurrent genital ulcerations, skin lesion, eye lesion, positive pathology test.
References
Chung MP, et al. Imaging of pulmonary vasculitis. Radiology 2010;255:322-341
Keywords
Vascular, Vasculitis,

No. of Applicants : 79

▶ Correct Answer : 22/79,  27.8%
  • - Juntendo University Hospital , Japan Akifumi Hagiwara
  • - Yokohama-asahi-chuo-general hospital , Japan Kyoko Nagai
  • - university of montreal , Canada Andrei Gorgos I
  • - University of Montreal Medical Center (CHUM) , Canada Carl Chartrand-Lefebvre
  • - radiologist, aditya imaging centre , India vivek patel
  • - McGill University Health Center , Canada Alexandre Semionov
  • - Government Medical College, Nagpur, India , India Krishna Prasad Bellam
  • - Niigata City General Hospital , Japan Takao Kiguchi
  • - Asan Medical Center , Korea (South) Soyeoun Lim
  • - Asan , Korea (South) Sania ALBlushi
  • - University of Tsukuba Hospital , Japan Sodai Hoshiai
  • - National Center hospital of Neurology and Psychiatry , Japan Kaoru Sumida
  • - IRSA La Rochelle , France Denis Chabassiere
  • - Pneumologia Universitaria, Policlinico di Bari , Italy Mario Damiani
  • - Kizawa Memorial Hospital , Japan Yo Kaneko
  • - Saitama-Sekishinkai Hosptal , Japan Mihoko Yamazaki
  • - Seirei Hamamatsu General Hospital , Japan Kenichi Mizuki
  • - Asan Medical Center , Korea (South) , Korea (South) Han Na Lee
  • - CLINIQUE STE CLOTILDE , Reunion patrick MASCAREL
  • - The University of Tokyo Hospital , Japan Takeyuki Watadani
  • - ZIGONG TCM HOSPITAL OF CHINA , China Cao Cunyou
  • - Nasaret Hospital , Korea (South) Hee Seok Choi
▶ Correct Answer as Differential Diagnosis : 22/79,  27.8%
  • - Daejin Medical Center Bundang Jesaeng General Hospital , Korea (South) Donghwan Kim
  • - Union hospital,Wuhan , China Nan Diao
  • - The University of Tokyo Hospital , Japan Toshihiro Furuta
  • - Fortis hospital , Mohali , India Shaleen Rana
  • - Freelance resident in Reunion Island , Reunion Fabien HO
  • - GHICL , France manuel toledano
  • - chonnam national university hospital , Korea (South) Kim eun
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - All India Institute of Medical Sciences , India Ashish Gupta
  • - University of Tsukuba, Dept of Radiologt , Japan Manabu Minami
  • - University of Tsukuba Hospital , Japan Hiroaki Takahashi
  • - Niigata University , Japan Atsushi Uehara
  • - KEM ,MUMBAI , India SHAH ALAM
  • - CLCC Rennes , France nicolas gautier
  • - CHU Poitiers , France CHAN paul
  • - Saint Malo , France jean-baptiste Noel
  • - Wuhan Union Hospital , China Qiguang Cheng
  • - IRSA LA ROCHELLE , France, Metropolitan BIGOT
  • - Diagnose.me (BV) / Royal Perth Hospital , Australia Yuranga Weerakkody
  • - Centre Imagerie de Fribourg , Switzerland Benoit RIZK
  • - Gifu Central Hospital , Japan Haruo Watanabe
  • - Kizawa Memorial Hospital , Japan Shoji Okuda
▶ Semi-Correct Answer : 1/79,  1.3%
  • - University of British Columbia , Canada Amr Ajlan
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