Images

Doctor's Information

Name : Shahram
Family : Kahkouee
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 : fatemeh mousavian

Case Section

Chest Imaging

Patient's Information

Gender : Female
Age : 29

Clinical Summary

Male patient complaint acute onset pleuritic pain and cough

Imaging Findings

Multifocal subpleural consolidations with reversed halo sign.
Huge cardiomegaly is present with subtle pleural reaction bilaterally.

Differential Diagnosis

Initially it was thought of being highly specific for cryptogenic organizing pneumonia (COP), although only seen in about one fifth of patients with the disease Whilst the relative high specificity for the aforementioned entity is preserved, the sign has also been described on standard resolution CT with the following pathologies:
opportunistic invasive fungal infections (IFI)
pulmonary mucormycosis (PM),
invasive pulmonary aspergillosis (IPA)
paracoccidioidomycosis
polyangiits with granulomatosis (Wegener's granulomatosis)
sarcoidosis
pneumocystis pneumonia
tuberculosis
community-acquired pneumonia
lymphomatoid granulomatosis
lipoid pneumonitis
pulmonary neoplasms
pulmonary infarction
following radiation therapy and radiofrequency/microwave ablation of pulmonary malignancies

Final Diagnosis

infarction(proved by biopsy)

Discussion (Related Text)

Reversed halo sign (RHS), also known as the atoll sign, is defined as central ground-glass opacity (GGO) surrounded by denser consolidation of crescentic (forming more than three fourths of a circle) or ring (forming a complete circle) shape of at least 2 mm in thickness.

References

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