38 y/o man with dyspnea

 

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Doctor's Information

Name : Shahram
Family : Kahkoueei
Affiliation :Radiology Department, Masih Hospital, SBMU
Academic Degree : Assistant Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Maryam baharambeigi

 

Case Section

Chest Imaging

 

Patient's Information

Gender : Male
Age : 38

 

Clinical Summary

38 y/o man with dyspnea

 

Imaging Findings

CT scan reveals Diffuse bilateral ground glass nodular infiltration

 

Differential Diagnosis

Pulmonary edema , diffuse pulmonary infection

 

Final Diagnosis

Diffuse alveolar hemorrhage

 

Discussion (Related Text)

Diffuse pulmonary hemorrhage (DPH) is a sub type of pulmonary hemorrhage,where bleeding into the lung is diffuse. If the bleeding is into the alveolar spaces this can be further sub classified as diffuse alveolar hemorrhage. While the exact presentation can vary is has been classically associated with dyspnea in the setting of hemoptysis. It can occur with a number of causes which include vasculititis (Wegeners granulomatosis, Goodpasture syndrome), connective tissue disorders (systemic lupus erythematosus ), coagulative disorders, medications, inhaled toxins. Plain film demonstrates bilateral air-space consolidation with relative apical sparing. Chest ct may show areas of widespread ground glass opacity, crazy paving pattern , consolidation. In the sub acute phase HRCT may show fine diffuse nodular densities. In later stage there may also be evidence of interlobular septal thickening due to intralymphatic accumulation of haemosiderin.

 

References

1. Albelda SM, Gefter WB, Epstein DM et-al. Diffuse pulmonary hemorrhage: a review and classification. Radiology. 1985;154 (2): 289-97.
2.Primack SL, Miller RR, Müller NL. Diffuse pulmonary hemorrhage: clinical, pathologic, and imaging features. AJR Am J Roentgenol. 1995;164 (2): 295-300.

 

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