대한흉부영상의학회 Weekly Chest Cases

Case No : 219 Date 2002-01-05

Courtesy of Eun-Young Kang, M.D. / Korea University Guro Hospital, Seoul, Korea
Age/Sex 35 / M
Chief ComplaintCough and hemopysis for one month

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Diagnosis With Brief Discussion

Diagnosis: Behcet's Disease with Intracardiac Thrombus, Pulmonary Artery Aneurysm, and Pulmonary Infarction
Radiologic Findings: Chest radiograph shows several nodular opacities in right lung. On CT scans several small airspace consolidations in right lung subpleural areas, dilation of right interlobar artery with thrombus, and filling defects in right ventricle are seen. On echocardiogram, thrombi are seen in right atrium and right ventricle.
Brief Review: Behcet’s disease is a chronic multisystemic inflammatory disease of unknown etiology. Diagnosis requires the presence of oral ulcerations in addition to any two of four additional features: genital ulceration, ocular involvement, positive pathergy test, or skin manifestations. Intrathoracic manifestations of Behcet’s disease consist of thromboembolism of superior vena cava and/or other mediastinal veins, aneurysm of aorta and pulmonary arteries, pulmonary infarction and hemorrhage, pleural effusion, and rarely myocardial or pericardial involvement, cor pulmonale, and mediastinal and hilar lymphadenopathies. Intracardiac thrombus is a rare but serious complication of Behcet’s disease.
References: 1. Turnaci A, Berkmen YM, Gokmen E. Thoracic involvement in Behcet’s disease: pathologic, clinical, and imaging features. AJR 1995;164:51-56
2. Ahn JM, Im JG, Rhoo JW, et al. Thoracic manifestations of Behcet syndrome: radiographic and CT findings in nine patients. Radiology 1995; 194:199-203
3. Mogulkoc. N, Burgess MI, Bishop PW. Intracardiac thrombus in Behcet’s disease. A systemic review. Chest 2000;118:479-487
4. Erkan F, Gul A, Tasali E. Pulmonary manifestations of Behcet’s disease. Thorax 2001;56:572-578
Keywords: Vascular, Lung, Vasculitis,

No. of Applicants : 21

▶ Correct Answer : 15/21, 71.4%

- Ansung Public Health Center, Korea Joon Woo Lee
- Asan Medical Center, Korea Seung Soo Lee
- Choong-ju Hospital Konkuk University, Korea Chang Hee Lee
- CHU Nancy-Brabois, France Denis Regent
- Gochang Hospital, Korea Jiyong Rhee
- Hangang Sacred Heart Hospital, Korea Eil Seong Lee
- Harasanshin hospital, Fukuoka, Japan Shunya Sunami
- IMSL, metz, France Eric Gaconnet
- Korea Cancer Center Hospital, Korea Donghee Park
- Ospedale di Jesi, Italy Giancarlo Passarini
- PyungChang Public Health Center Bangrim branch, Korea Seong Joon Kim
- Samsung Medical Center, Korea Young Cheol Yoon
- Stedelijk OLV Ziekenhuis Mechelen, Belgium Ivan Pilate
- Sungji Hospital, Korea Jung Hee Kim
- Wallaece Memorial Baptist Hospital,Korea Mi Ok Sun Woo

▶ Semi-Correct Answer : 4/21, 19.0%

- Inha University Hospital, Korea Dong-Jae Shim
- MH[CTC] PUNE, INDIA Vivek Sharma
- Pulmonary Medicine Doctor, Korea Jae-Joon Yim
- R G Gopinath

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 219 Date 2002-01-05

Discussion

No. of Applicants : 21