Learning objectives
To be familiar with the important clinical and histopathologic findings of various infectious diseases,
which involve subpleural area of lung parenchyma.
To illustrate the radiologic appearances of these various infectious diseases and to discuss the differential diagnosis.
Background
Various infectious diseases (actinomycosis,
parasitic infestation,
tuberculosis,
fungal infection,
septic pneumonia..) as well as lung cancer can involve subpleural area of lung as a nodular or mass-like subpleural consolidation mimicking malignancy.
Differential diagnosis of these benign infectious diseases from malignant lesion or organ specific diagnosis is often difficult.
However,
image based proper diagnosis can help to ovoid invasive diagnostic procedure including unnecessary surgery and to improve treatment by appropriate choice of anti-microbial agent.
Therefore,
an understanding of image findings of these infectious diseases according to...
Findings and procedure details
Actinomycosis
Thoracic actinomycosis is a chronic suppurative pulmonary or endobronchial infection caused by Actinomyces israelii,
a gram-positive anaerobic saprophytic orgamism in the oral cavity.
Actinomycosis typically follows aspiration of endogenous organisms of the oropharynx into the lungs in people with poor oral hygiene or from extension of cervicofacial infections.
Confirmative diagnosis: histopathology
- Histopathologic findings of Actinomyces colonies or sulfur granules (yellowish aggregates of clustered mycelia)
- Filamentous structures within the tissue specimen positive for Grocott-Gomori methenamine-silver staining
CT findings
- Typical findings: chronic segmental...
Conclusion
Pulmonary subpleural nodular or mass-like consolidation may be seen in wide spectrum of pulmonary infectious diseases as well as malignancy.
Radiologist should be aware of useful image findings for the differential diagnosis of these infectious diseases.
Personal information
S.
M.
Moon,
Department of Radiology,
Chonnam National University Hospital,
Gwangu,
South Korea
D.
Lee,
Department of Radiology,
Chonnam National University Hospital,
Gwangu,
South Korea
H.
J.
Seon,
Department of Radiology,
Chonnam National University Hospital,
Gwangu,
South Korea
Y.
H.
Kim,
Department of Radiology,
Chonnam National University Hospital,
Gwangu,
South Korea
References
1.
Thoracic actinomycosis: CT features with histopathologic correlation.
Kim TS,
Han J,
Koh WJ,
Choi JC,
Chung MJ,
Lee JH,
Shim SS,
Chong S.
AJR Am J Roentgenol.
2006 Jan;186(1):225-31.
2.
Pulmonary paragonimiasis: clinical and experimental studies.
Im JG,
Kong Y,
Shin YM,
Yang SO,
Song JG,
Han MC,
Kim CW,
Cho SY,
Ham EK.
Radiographics.
1993 May;13(3):575-86.
3.
Pleuropulmonary paragonimiasis: CT findings in 31 patients.
Kim TS,
Han J,
Shim SS,
Jeon K,
Koh WJ,
Lee I,
Lee KS,
Kwon OJ.
AJR Am J...