대한흉부영상의학회 Korean Society of Thoracic Radiology

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Weekly Chest CasesCases by Disease Category

Case No : 1272 Date 2022-03-07

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  • Courtesy of Kyung Hee Lee / Inha University Hospital
  • Age/Sex 46 / M
  • Chief ComplaintDyspnea
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5
  • Figure 6

Diagnosis With Brief Discussion

Diagnosis
Unilateral pulmonary edema due to mitral regurgitation (mitral valve prolapse)
Radiologic Findings
Fig 1. Chest PA shows central dominant peribronchovascular consolidation and GGO in right lung and small right pleural effusion.
Fig 2-6. CT scans reveal RUL and central dominant peribronchovascular consolidation, GGO with interlobular septal thickening in right lung and right pleural effusion. LA enlargement is noted.
Brief Review
Hydrostatic edema is usually bilateral and symmetric. In patients with hydrostatic edema, variations in the distribution of the edema fluid may result from variations in blood flow or hydrostatic pressure (or other mechanisms). Unilateral or asymmetric edema may result. The most common cause of unilateral edema is the decubitus position. Right upper lobe edema may be seen in patients with papillary muscle rupture and mitral regurgitation; this is caused by a jet of regurgitant blood directed into the right superior pulmonary vein. Patients with decreased blood flow to one lung (e.g. pulmonary artery occlusion) tend to develop edema on the opposite side. This also may be seen in patients with unilateral lung abnormalities resulting in decreased blood flow, such as pulmonary embolism or Swyer-James syndrome.
References
W. Richard Webb, Charles B. Higgins. Thoracic Imaging. 3rd ed. Wolters Kluwer 2017:377
Keywords
Unilateral pulmonary edema,

No. of Applicants : 113

▶ Correct Answer : 77/113,  68.1%
  • - Ishikawa Matto Central Hospital , Japan MANABU AKIMOTO
  • - Korea University Guro Hospital , Korea (South) SEOKYOUNG LEE
  • - , Japan JUN KANZAWA
  • - ZIGONG TCM HOSPITAL OF CHINA , China CAO CUN YOU
  • - Showa General Hospital , Japan MASAFUMI KAIUME
  • - Ajou University Hospital , Korea (South) SUNG HYUN AN
  • - , France ANNE-LAURE LEJEUNE
  • - Affilitated Hospital of Jining Medical college , China JIANG SHENG HUA
  • - , United Kingdom SAMSON KADE
  • - McGill University Health Center , Canada ALEXANDRE SEMIONOV
  • - NIMS, HYDERABAD , India BHASKAR K
  • - National Center of Neurology and Psychiatry , Japan MOTO NAKAYA
  • - , Italy PAOLO BALDASSARI
  • - , Japan CHIAKI SATO
  • - Chonnam National University Hwasun Hospital , Korea (South) HONG SEOK CHOI
  • - Other , Korea (South) HWANGHEE JO
  • - Chungbuk National University Hospital , Korea (South) JIYUN KANG
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Ajou University Hospital , Korea (South) KYUNGMIN LEE
  • - Other , Korea (South) SEONGSU KANG
  • - Scans world , India PHILSON JOSEPH MUKKADA
  • - Manipal HealthMap , India SHASHANK SOOD
  • - Chonbuk National University Hospital , Korea (South) JUNGHWAN KIM
  • - Korea University Ansan Hospital , Korea (South) HYO YOUNG KIM
  • - Kaneda hospital , Japan HIROFUMI MIFUNE
  • - , Korea (South) SUNHYANG LEE
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Ajou University Hospital , Korea (South) MINJI KIM
  • - Inje University Pusan Paik Hospital , Korea (South) JIYEON HAN
  • - , Korea (South) JAYOUNG MOON
  • - Gifu University Hospital , Japan Yo Kaneko
  • - McGill , Canada MUTAZ ADNAN KHAIRO
  • - Kyoto University Hospital , Japan YASUHISA KURATA
  • - The University of Tokyo Hospital , Japan RYO KUROKAWA
  • - Ajou University Hospital , Korea (South) YOU NA KIM
  • - Other , Korea (South) MARI A
  • - , United States HIROAKI TAKAHASHI
  • - , Brazil MARCELO B G FUNARI
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey MERIC TUZUN
  • - Chungbuk National University Hospital , Korea (South) MIHYEON PARK
  • - Other , Korea (South) MIN A LEE
  • - Chungbuk National University Hospital , Korea (South) MINJI SONG
  • - Other , Korea (South) MINSU KIM
  • - Centre Hospitalier Regional de Lanaudiere , Canada MATTHIEU STORME
  • - none , Mongolia MUNKHGEREL DAVAA
  • - Eskisehir Sehir Hastanesi , Turkey MURAT SAHIN
  • - , Qatar NABIL SHERIF MAHMOOD
  • - Chungbuk National University Hospital , Korea (South) CHANSEOP KIM
  • - Osaka city university Hospital , Japan TATSUSHI OURA
  • - Azienda Ospedaliera di Cremona , Italy Pietro Sergio
  • - Other , Korea (South) SEONG WON JANG
  • - Chungbuk National University Hospital , Korea (South) PARK JUN HYEON
  • - Manipal hospital Hebbal ,Bengaluru , India PRAVIN KUMAR M
  • - Holy Family Hospital , India RAJESH GOTHI
  • - Asan Medical Center , Korea (South) BYUNGSOO IM
  • - Other , Korea (South) KYU-CHONG LEE
  • - Kyoto University Hospital , Japan SATOSHI IKEDA
  • - Samsung Medical Center , Korea (South) SUHO KIM
  • - Seoul National University Bundang Hospital , Korea (South) YOONAH DO
  • - Chonbuk National University Hospital , Korea (South) MINJEE KIM
  • - Yonsei University,Severance Hospital , Korea (South) SUJI LEE
  • - Toranomon Hospital , Japan KAORU SUMIDA
  • - Other , Korea (South) SUNYOUNG PARK
  • - Chonbuk National University Hospital , Korea (South) DONG HAN SHIN
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - TAKANA HAYASHI
  • - The University of Tokyo Hospital , Japan HIROSHI TAKUMIDA
  • - , Japan KAZUMA TERAUCHI
  • - suzhou , China DR. WANG
  • - Sotiria Hospital, Athens , Greece VASILIOS TZILAS
  • - , Japan YUMI MAEHARA
  • - , Japan YUKI HAYASHI
  • - , Korea (South) WONJU HONG
  • - , Korea (South) HM PARK
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - Hanyang University Hospital , Korea (South) SEUNG JIN YOO
  • - algeria , Algeria ZAKARIA CHERAGA
▶ Correct Answer as Differential Diagnosis : 9/113,  8.0%
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Tiger Gate Hospital , Japan SHIN-ICHI CHO
  • - Asan Medical Center , Korea (South) EUNJI CHOI
  • - , Korea (South) HYUNSEUNG LEE
  • - , Korea (South) YEONG UK HWANG
  • - , Japan MIDORI UENO
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - , Albania AN G
  • - Chonnam National University Hospital , Korea (South) KIM SANG GYUN
▶ Semi-Correct Answer : 2/113,  1.8%
  • - , China FANG YING GEN
  • - Osmania Medical College, Hyderabad , India PURUSHOTHAMA RAO TUMMALA
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