Rapidly progressive pulmonary opacities on thoracic imaging studies

Michael Gotway, Paul J. Conomos

Research output: Contribution to journalArticle

Abstract

Thoracic imaging studies showing the rapid development of multifocal, bilateral pulmonary opacities are common in clinical practice. From an imaging standpoint, such patients may be broadly classified into those with hydrostatic pulmonary edema versus those with increased permeability edema patterns; combinations of these two patterns may also be encountered. Classification of patients into one or the other pattern provides an approach to the thoracic imaging findings in these patients and may even allow tailoring of additional diagnostic studies and presumptive therapy.In addition to a number of commonly encountered etiologies for an increased permeability pattern on chest radiography, several conditions primarily characterized by interstitial and/or alveolar inflammation or pulmonary hemorrhage should be considered, among them acute eosinophilic pneumonia. Acute eosinophilic pneumonia often presents in previously healthy patients without a prior history of asthma, usually without peripheral blood eosinophilia, and produces respiratory failure. Thoracic imaging studies show rapidly progressing multifocal bilateral air-space consolidation without features of hydrostatic pulmonary edema. Bronchoscopy is the diagnostic procedure of choice and will show significant pulmonary eosinophilia on bronchoalveolar lavage. Corticosteroid therapy causes clearing of the pulmonary findings and rapid resolution of respiratory failure. Relapse is not a feature of acute eosinophilic pneumonia.

Original languageEnglish (US)
Pages (from-to)300-303
Number of pages4
JournalClinical Pulmonary Medicine
Volume15
Issue number5
DOIs
StatePublished - Sep 2008
Externally publishedYes

Fingerprint

Pulmonary Eosinophilia
Thorax
Lung
Pulmonary Edema
Respiratory Insufficiency
Permeability
Eosinophilia
Bronchoscopy
Bronchoalveolar Lavage
Radiography
Edema
Pneumonia
Adrenal Cortex Hormones
Asthma
Air
Hemorrhage
Recurrence
Therapeutics

Keywords

  • Chest radiography
  • Computed tomography
  • Eosinophilic pneumonia
  • Peripheral

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Pulmonary and Respiratory Medicine

Cite this

Rapidly progressive pulmonary opacities on thoracic imaging studies. / Gotway, Michael; Conomos, Paul J.

In: Clinical Pulmonary Medicine, Vol. 15, No. 5, 09.2008, p. 300-303.

Research output: Contribution to journalArticle

@article{8a1c0943a4764022a692c32308fb7b2c,
title = "Rapidly progressive pulmonary opacities on thoracic imaging studies",
abstract = "Thoracic imaging studies showing the rapid development of multifocal, bilateral pulmonary opacities are common in clinical practice. From an imaging standpoint, such patients may be broadly classified into those with hydrostatic pulmonary edema versus those with increased permeability edema patterns; combinations of these two patterns may also be encountered. Classification of patients into one or the other pattern provides an approach to the thoracic imaging findings in these patients and may even allow tailoring of additional diagnostic studies and presumptive therapy.In addition to a number of commonly encountered etiologies for an increased permeability pattern on chest radiography, several conditions primarily characterized by interstitial and/or alveolar inflammation or pulmonary hemorrhage should be considered, among them acute eosinophilic pneumonia. Acute eosinophilic pneumonia often presents in previously healthy patients without a prior history of asthma, usually without peripheral blood eosinophilia, and produces respiratory failure. Thoracic imaging studies show rapidly progressing multifocal bilateral air-space consolidation without features of hydrostatic pulmonary edema. Bronchoscopy is the diagnostic procedure of choice and will show significant pulmonary eosinophilia on bronchoalveolar lavage. Corticosteroid therapy causes clearing of the pulmonary findings and rapid resolution of respiratory failure. Relapse is not a feature of acute eosinophilic pneumonia.",
keywords = "Chest radiography, Computed tomography, Eosinophilic pneumonia, Peripheral",
author = "Michael Gotway and Conomos, {Paul J.}",
year = "2008",
month = "9",
doi = "10.1097/CPM.0b013e3181850e08",
language = "English (US)",
volume = "15",
pages = "300--303",
journal = "Clinical Pulmonary Medicine",
issn = "1068-0640",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Rapidly progressive pulmonary opacities on thoracic imaging studies

AU - Gotway, Michael

AU - Conomos, Paul J.

PY - 2008/9

Y1 - 2008/9

N2 - Thoracic imaging studies showing the rapid development of multifocal, bilateral pulmonary opacities are common in clinical practice. From an imaging standpoint, such patients may be broadly classified into those with hydrostatic pulmonary edema versus those with increased permeability edema patterns; combinations of these two patterns may also be encountered. Classification of patients into one or the other pattern provides an approach to the thoracic imaging findings in these patients and may even allow tailoring of additional diagnostic studies and presumptive therapy.In addition to a number of commonly encountered etiologies for an increased permeability pattern on chest radiography, several conditions primarily characterized by interstitial and/or alveolar inflammation or pulmonary hemorrhage should be considered, among them acute eosinophilic pneumonia. Acute eosinophilic pneumonia often presents in previously healthy patients without a prior history of asthma, usually without peripheral blood eosinophilia, and produces respiratory failure. Thoracic imaging studies show rapidly progressing multifocal bilateral air-space consolidation without features of hydrostatic pulmonary edema. Bronchoscopy is the diagnostic procedure of choice and will show significant pulmonary eosinophilia on bronchoalveolar lavage. Corticosteroid therapy causes clearing of the pulmonary findings and rapid resolution of respiratory failure. Relapse is not a feature of acute eosinophilic pneumonia.

AB - Thoracic imaging studies showing the rapid development of multifocal, bilateral pulmonary opacities are common in clinical practice. From an imaging standpoint, such patients may be broadly classified into those with hydrostatic pulmonary edema versus those with increased permeability edema patterns; combinations of these two patterns may also be encountered. Classification of patients into one or the other pattern provides an approach to the thoracic imaging findings in these patients and may even allow tailoring of additional diagnostic studies and presumptive therapy.In addition to a number of commonly encountered etiologies for an increased permeability pattern on chest radiography, several conditions primarily characterized by interstitial and/or alveolar inflammation or pulmonary hemorrhage should be considered, among them acute eosinophilic pneumonia. Acute eosinophilic pneumonia often presents in previously healthy patients without a prior history of asthma, usually without peripheral blood eosinophilia, and produces respiratory failure. Thoracic imaging studies show rapidly progressing multifocal bilateral air-space consolidation without features of hydrostatic pulmonary edema. Bronchoscopy is the diagnostic procedure of choice and will show significant pulmonary eosinophilia on bronchoalveolar lavage. Corticosteroid therapy causes clearing of the pulmonary findings and rapid resolution of respiratory failure. Relapse is not a feature of acute eosinophilic pneumonia.

KW - Chest radiography

KW - Computed tomography

KW - Eosinophilic pneumonia

KW - Peripheral

UR - http://www.scopus.com/inward/record.url?scp=67649621602&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67649621602&partnerID=8YFLogxK

U2 - 10.1097/CPM.0b013e3181850e08

DO - 10.1097/CPM.0b013e3181850e08

M3 - Article

VL - 15

SP - 300

EP - 303

JO - Clinical Pulmonary Medicine

JF - Clinical Pulmonary Medicine

SN - 1068-0640

IS - 5

ER -