Imaging
Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary, Critical Care & Sleep publishes case-based articles with characteristic chest imaging and related pathology.
The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend. Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary, Critical Care & Sleep publishes case-based articles with characteristic chest imaging and related pathology. The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend.
Medical Image of the Week: Idiopathic Pulmonary Hemosiderosis
Figure 1. Representative axial high-resolution CT (HRCT) scan sections demonstrating increased attenuation of the lungs due to diffuse groundglass opacification with subpleural and scattered clustered cysts most evident in the upper lung zones.
The patient is a 40 year-old man who was diagnosed with Idiopathic Pulmonary Hemosiderosis (IPH) at the age of three. He has recurrent episodes of hemoptysis several times a year that are controlled with increased doses of prednisone. He is chronically on 10 mg daily which usually control his symptoms. A HRCT scan of the chest shows predominantly upper lung cystic changes both subpleural and clustered with a honeycomb appearance superimposed on a background of diffuse ground glass opacification.
Typical HRCT findings include patchy scattered areas of ground glass opacity and consolidation that usually involve the perihilar and lower aspects of the lungs. However, case reports of rare findings of multiple honeycomb cystic changes have been reported that are thought to be a result of progressive fibrotic changes from hemosiderin deposition in the interstitium (1). These honeycomb cysts may represent sites of more severe and recurrent alveolar hemorrhage in adults with IPH and are probably related to a traction phenomenon secondary to interstitial fibrosis following recurrent episodes of alveolar hemorrhage.
Nathaniel Reyes MD*, Linda Snyder MD*, Veronica Arteaga MD+
Department of Medicine, Division of Pulmonary and Critical Care Medicine*
Department of Radiology+
University of Arizona, Tucson, Arizona
Reference
- Harte S, McNicholas WT, Donnelly SC, Dodd JD. Honeycomb cysts in idiopathic pulmonary haemosiderosis: high-resolution CT appearances in two adults. Br J Radiol. 2008;81(972):e295-8. [CrossRef] [PubMed]
Reference as: Reyes N, Snyder L, Arteaga V. Medical image of teh week: idiopathic pulmonary hemosiderosis. Southwest J Pulm Crit Care. 2014;9(1):30-1. doi: http://dx.doi.org/10.13175/swjpcc092-14 PDF