This document is a presentation on CT halo sign by Dr. Mazen Qusaibaty. It discusses what the CT halo sign refers to and provides examples of diseases that can present with the halo sign, including aspergillosis, eosinophilic pneumonia, bronchiolitis obliterans with organizing pneumonia, and others. Specific case examples are presented to illustrate the halo sign in diseases such as invasive pulmonary aspergillosis, Kaposi sarcoma, and eosinophilic pneumonia. The histological features underlying the halo sign are also described for different conditions.
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Ct halo sign (part 1)
1. Dr Mazen Qusaibaty
MD, DIS
Head Pulmonary and Internist
Department
Ibnalnafisse Hospital
Ministry of Syrian health
Email: Qusaibaty@gmail.com
1. CT halo sign
(part 1)
10. Halo sign could be seen in:
A. Aspergillosis
B. Eosinophilic Pneumonia
C. Bronchiolitis Obliterans with Organizing
Pneumonia
D. Thoracic Endometriosis
E. Focal Traumatic Lung Injury
F. All above
10
11. Halo sign could be seen in:
A. Aspergillosis
B. Eosinophilic Pneumonia
C. Bronchiolitis Obliterans with Organizing
Pneumonia
D. Thoracic Endometriosis
E. Focal Traumatic Lung Injury
F. All above.
11
14. Aspergillosis
• Aspergillosis may be
manifested as areas
of nodular ground-
glass opacity
14 http://radiographics.rsna.org/content/27/2/391.full
15. Photomicrograph of a histologic specimen (original magnification, ×100;
hematoxylin-eosin stain) shows an aspergillus colony (arrows) and a surrounding
area of intraalveolar hemorrhage (arrowheads)
16
http://radiographics.rsna.org/content/27/2/391/F24.expansion.html
19. The clinicopathologic features and radiologic
manifestations of aspergillosis depend on
• Patient immunity
20 http://radiographics.rsna.org/content/27/2/391.full
20. The clinicopathologic features and radiologic
manifestations of aspergillosis depend on
• The presence of
structural lung
disease
21 http://radiographics.rsna.org/content/27/2/391.full
21. The clinicopathologic features and radiologic
manifestations of aspergillosis depend on
• The virulence of the
fungal species
involved
22 http://radiographics.rsna.org/content/27/2/391.full
22. Quiz
• A 50-year-old woman treated with a high
dosage of steroids to reduce cerebral edema
from anaplastic oligodendroglioma
ِةَلْيِلَقالنُّصَغالت ُمَرَوِتاَّيِقْبِالد
23
27. Invasive
Pulmonary Aspergillosis
• A large mass is seen in
the posterior segment
of right upper lobe,
surrounded by a wide
zone of ground-glass
attenuation (arrow)
• Demonstrating the halo
sign
28
30. Invasive
Pulmonary Aspergillosis
• A smaller mass
(arrowhead) is seen in
LLL:
A. Superior Segment
B. Lateral Basal Segment
C. Posterior Basal
Segment
31
31. Invasive
Pulmonary Aspergillosis
• A smaller mass
(arrowhead) is seen in
LLL:
A. Superior Segment
B. Lateral Basal Segment
C. Posterior Basal
Segment
32
32. Case
• A 39-year-old man with acute myelogenous
leukaemia and neutropenia
33
http://bjr.birjournals.org/cgi/content/full/78/933/862#T1
33. Thin-section CT at the level of the lung apex
• Shows multiple
nodules surrounded
by a halo of ground
glass opacity in both
upper lobes
34
http://bjr.birjournals.org/cgi/content/full/78/933/862#T1
Invasive pulmonary
aspergillosis
34. • CT shows nodular consolidation associated with a
halo of ground-glass opacity (GGO) in both apices
resulting from invasive pulmonary aspergillosis
35
35. • This halo represents hemorrhage.
• When seen in leukemic patients, is highly suggestive
of the diagnosis of invasive pulmonary aspergillosis.
36
36. Case
• A 45-year-old
woman with rapidly
progressive
glomerulonephritis.
• Low grade fever +
mild cough and
dyspnea + a
weakness
37
http://bjr.birjournals.org/cgi/content/full/78/933/862#T1
37. Thin-section CT of the right lung base
• Multiple tiny
nodules (arrows) with
the CT halo sign in
the right lower lobe
38
http://bjr.birjournals.org/cgi/content/full/78/933/862#T1
38. Quiz/ This patient has pneumonia caused by:
A. Adenovirus
B. Cytomegalovirus
C. Aspergillosis
D. Staphylococcus
aureus
E. E.Coli
39
http://bjr.birjournals.org/cgi/content/full/78/933/862#T1
39. Quiz/ This patient has pneumonia caused by:
A. Adenovirus
B. Cytomegalovirus
C. Aspergillosis
D. Staphylococcus
aureus
E. E.Coli
40
http://bjr.birjournals.org/cgi/content/full/78/933/862#T1
41. Kaposi sarcoma in a 29-year-old woman with a
history of renal transplantation
• Thin-section CT at
the level of the
carina
42
http://bjr.birjournals.org/cgi/content/full/78/933/862#T1
42. Kaposi sarcoma in a 29-year-old woman with a
history of renal transplantation
• shows multiple
nodules with a
surrounding halo of
ground glass opacity
in both lungs
43
http://bjr.birjournals.org/cgi/content/full/78/933/862#T1
43. Kaposi sarcoma in a 29-year-old woman with a
history of renal transplantation
• Flame-shaped
lesions
• The classic findings
of Kaposi sarcoma.
44
http://bjr.birjournals.org/cgi/content/full/78/933/862#T1
44. Quiz / Thin-section CT obtained at the level of
the
A. Bronchus superior
B. Bronchus
intermedius
C. Bronchus inferior
45 http://bjr.birjournals.org/cgi/content-nw/full/78/933/862/F4
45. Quiz / Thin-section CT obtained at the level of
the
A. Bronchus superior
B. Bronchus
intermedius
C. Bronchus inferior
46 http://bjr.birjournals.org/cgi/content-nw/full/78/933/862/F4
46. • A peripheral
pulmonary nodule
with the CT halo sign
47 http://bjr.birjournals.org/cgi/content-nw/full/78/933/862/F4
47. What diagnosis that do you expect?
A. Streptococcus
pneumonia
B. Bronchioloalveolar
carcinoma
C. Kaposi Sarcoma
D. Pneumocystis
carinii (P. jirovecii)
pneumonia
48 http://bjr.birjournals.org/cgi/content-nw/full/78/933/862/F4
48. What diagnosis that do you expect?
A. Streptococcus
pneumonia
B. Bronchioloalveolar
carcinoma
C. Kaposi Sarcoma
D. Pneumocystis carinii
(P. jirovecii)
pneumonia
49 http://bjr.birjournals.org/cgi/content-nw/full/78/933/862/F4
50. Eosinophilic Pneumonia
Eosinophilic lung
disease may
occur in various
conditions
Parasitic infection
Idiopathic pulmonary fibrosis
Sarcoidosis
Collagen vascular
disease
Hypereosinophilic
syndrome
Drug reactions
51
HayakawaH, Sato A, Toyoshima M, Imokawa S, Taniguchi M. A clinical study of idiopathic
eosinophilic pneumonia. Chest 1994; 105:1462–1466.
51. Halo sign / Eosinophilic Pneumonia
Eosinophilic lung
disease
Parasitic infection (Loeffler syndrome)
Hypereosinophilic syndrome
52
HayakawaH, Sato A, Toyoshima M, Imokawa S, Taniguchi M. A clinical study of idiopathic
eosinophilic pneumonia. Chest 1994; 105:1462–1466.
53. Histologically
Solid portion
A neutrophilic
abscess
54
KimY, Lee KS, Jung KJ, Han J, Kim JS, Suh JS. Halo sign on high resolution CT: findings in spectrum of
pulmonary diseases with pathologic correlation. J Comput Assist Tomogr 1999; 23: 622–626.
54. Thin-section CT
• Shows multiple small
nodules (arrows) in RLL
with a surrounding
halo of ground glass
opacity in the right
lower lobe
55
http://bjr.birjournals.org/cgi/content/full/78/933/862/F6
55. What diagnosis that do you expect?
A. Sarcoidosis
B. Idiopathic
pulmonary fibrosis
C. Drug reactions
D. Loeffler syndrome
56
http://bjr.birjournals.org/cgi/content/full/78/933/862/F6
56. What diagnosis that do you expect?
A. Sarcoidosis
B. Idiopathic
pulmonary fibrosis
C. Drug reactions
D. Loeffler syndrome
57
http://bjr.birjournals.org/cgi/content/full/78/933/862/F6
57. Simple pulmonary eosinophilia
(Loeffler syndrome)
• In a 42-year-old man
with peripheral
eosinophilia
• 53.5% of eosinophils
in the peripheral
blood
58
http://bjr.birjournals.org/cgi/content/full/78/933/862/F6
58. Thin-section CT image at the level of the
aortic arch
59 http://radiographics.rsna.org/content/27/2/391/F26.expansion.html
59. An ill-defined area of nodular ground-glass
opacity in the upper lobe of the right lung
60 http://radiographics.rsna.org/content/27/2/391/F26.expansion.html
60. What diagnosis that do you expect in a 36-
year-old man?
A. Sarcoidosis
B. Eosinophilic
pneumonia
C. Idiopathic
pulmonary fibrosis
D. Drug reactions
E. Lupus
61 http://radiographics.rsna.org/content/27/2/391/F26.expansion.html
61. What diagnosis that do you expect in a 36-
year-old man?
A. Sarcoidosis
B. Eosinophilic
pneumonia
C. Idiopathic
pulmonary fibrosis
D. Drug reactions
E. Lupus
62 http://radiographics.rsna.org/content/27/2/391/F26.expansion.html
63. Quiz
Ground-glass opacity at the level of
A. The left upper lobar
bronchus
B. The left lower lobar
bronchus
64 http://radiographics.rsna.org/content/27/2/391/F27.expansion.html
64. Quiz
Ground-glass opacity at the level of
A. The left upper lobar
bronchus
B. The left lower lobar
bronchus
65 http://radiographics.rsna.org/content/27/2/391/F27.expansion.html
MF
65. Quiz
Ground-glass opacity at the level of the left upper lobar
bronchus
A. Apical Posterior
Segment
B. Anterior Segment
C. Lingula Superior
Segment
D. Lingula Inferior
Segment
66 http://radiographics.rsna.org/content/27/2/391/F27.expansion.html
66. Quiz
Ground-glass opacity at the level of the left upper lobar
bronchus
A. Apical Posterior
Segment
B. Anterior Segment
C. Lingula Superior
Segment
D. Lingula Inferior
Segment
67 http://radiographics.rsna.org/content/27/2/391/F27.expansion.html
69. Case
• Thin-section CT
shows a pulmonary
nodule with the CT
halo sign in the left
lower lobe (thick arrow).
70
http://bjr.birjournals.org/cgi/content-nw/full/78/933/862/F5
70. Note another nodule in without surrounding
ground glass opacity (thin arrow) in the:
A. Right middle lobe
B. Right upper lobe
C. Right lower lobe
71
http://bjr.birjournals.org/cgi/content-nw/full/78/933/862/F5
71. Note another nodule in without surrounding
ground glass opacity (thin arrow) in the:
A. Right middle lobe
B. Right upper lobe
C. Right lower lobe
72
http://bjr.birjournals.org/cgi/content-nw/full/78/933/862/F5
72. What diagnosis that do you expect?
A. Sarcoidosis
B. Wegener's
granulomatosis
C. Idiopathic
pulmonary fibrosis
D. Drug reactions
E. Loeffler syndrome
73
http://bjr.birjournals.org/cgi/content-nw/full/78/933/862/F5
73. What diagnosis that do you expect?
A. Sarcoidosis
B. Wegener's
granulomatosis
C. Idiopathic
pulmonary fibrosis
D. Drug reactions
E. Loeffler syndrome
74
http://bjr.birjournals.org/cgi/content-nw/full/78/933/862/F5
75. Reverse halo sign: Wegener's granulomatosis
• Many nodules show central areas of ground
glass opacity, with surrounding consolidation.
76
76. Reverse halo sign: Wegener's granulomatosis
• High-resolution CT scan of the chest shows
bilateral nodular opacities with areas of
patchy consolidation.
77
Editor's Notes
A Pictorial Review of “Signs in Thoracic Imaging”Karuppasamy, K.1, Abhyankar-Gupta, M.1, Fewins, H.1, Curtis, J.21The Cardiothoracic Centre - Liverpool NHS Trust, 2Aintree University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
Refers to a zone of ground-glass attenuation (the halo) surrounding a pulmonary nodule or mass or consolidation
Aspergillosis
Infectious conditions such as aspergillosis may be manifested at thin-section CT as areas of nodular ground-glass opacity, an appearance caused by hemorrhage or inflammatory cell infiltration (10) (Fig 10a). The clinicopathologic features and radiologic manifestations of aspergillosis depend on patient immunity, the presence of structural lung disease, and the virulence of the fungal species involved (33–35).
Won et al (36), in a study of patients with invasive pulmonary aspergillosis, found segmental consolidation or a nodule with surrounding ground-glass opacity (a CT halo sign) on thin-section CT images. The surrounding region of ground-glass opacity represents alveolar hemorrhage related to infarction (Fig 10b) (37). Pinto (38) reported that the frequency of the CT halo sign ranged from 96% on day 0 to 19% on day 14 after disease onset. These CT findings may be early indicators of invasive aspergillosis in severely neutropenic febrile patients in whom antibiotic medications are ineffective.
Aspergillosis
Infectious conditions such as aspergillosis may be manifested at thin-section CT as areas of nodular ground-glass opacity, an appearance caused by hemorrhage or inflammatory cell infiltration (10) (Fig 10a). The clinicopathologic features and radiologic manifestations of aspergillosis depend on patient immunity, the presence of structural lung disease, and the virulence of the fungal species involved (33–35).
Won et al (36), in a study of patients with invasive pulmonary aspergillosis, found segmental consolidation or a nodule with surrounding ground-glass opacity (a CT halo sign) on thin-section CT images. The surrounding region of ground-glass opacity represents alveolar hemorrhage related to infarction (Fig 10b) (37). Pinto (38) reported that the frequency of the CT halo sign ranged from 96% on day 0 to 19% on day 14 after disease onset. These CT findings may be early indicators of invasive aspergillosis in severely neutropenic febrile patients in whom antibiotic medications are ineffective.
Photomicrograph of a histologic specimen (original magnification, ×100; hematoxylin-eosin stain) shows an aspergillus colony (arrows) and a surrounding area of intraalveolar hemorrhage (arrowheads).
Aspergillosis
Infectious conditions such as aspergillosis may be manifested at thin-section CT as areas of nodular ground-glass opacity, an appearance caused by hemorrhage or inflammatory cell infiltration (10) (Fig 10a). The clinicopathologic features and radiologic manifestations of aspergillosis depend on patient immunity, the presence of structural lung disease, and the virulence of the fungal species involved (33–35).
Won et al (36), in a study of patients with invasive pulmonary aspergillosis, found segmental consolidation or a nodule with surrounding ground-glass opacity (a CT halo sign) on thin-section CT images. The surrounding region of ground-glass opacity represents alveolar hemorrhage related to infarction (Fig 10b) (37). Pinto (38) reported that the frequency of the CT halo sign ranged from 96% on day 0 to 19% on day 14 after disease onset. These CT findings may be early indicators of invasive aspergillosis in severely neutropenic febrile patients in whom antibiotic medications are ineffective.
Aspergillosis
Infectious conditions such as aspergillosis may be manifested at thin-section CT as areas of nodular ground-glass opacity, an appearance caused by hemorrhage or inflammatory cell infiltration (10) (Fig 10a). The clinicopathologic features and radiologic manifestations of aspergillosis depend on patient immunity, the presence of structural lung disease, and the virulence of the fungal species involved (33–35).
Won et al (36), in a study of patients with invasive pulmonary aspergillosis, found segmental consolidation or a nodule with surrounding ground-glass opacity (a CT halo sign) on thin-section CT images. The surrounding region of ground-glass opacity represents alveolar hemorrhage related to infarction (Fig 10b) (37). Pinto (38) reported that the frequency of the CT halo sign ranged from 96% on day 0 to 19% on day 14 after disease onset. These CT findings may be early indicators of invasive aspergillosis in severely neutropenic febrile patients in whom antibiotic medications are ineffective.
Aspergillosis
Infectious conditions such as aspergillosis may be manifested at thin-section CT as areas of nodular ground-glass opacity, an appearance caused by hemorrhage or inflammatory cell infiltration (10) (Fig 10a). The clinicopathologic features and radiologic manifestations of aspergillosis depend on patient immunity, the presence of structural lung disease, and the virulence of the fungal species involved (33–35).
Won et al (36), in a study of patients with invasive pulmonary aspergillosis, found segmental consolidation or a nodule with surrounding ground-glass opacity (a CT halo sign) on thin-section CT images. The surrounding region of ground-glass opacity represents alveolar hemorrhage related to infarction (Fig 10b) (37). Pinto (38) reported that the frequency of the CT halo sign ranged from 96% on day 0 to 19% on day 14 after disease onset. These CT findings may be early indicators of invasive aspergillosis in severely neutropenic febrile patients in whom antibiotic medications are ineffective.
Transverse CT scan obtained in a 50-year-old woman with invasive
pulmonary aspergillosis treated with a high dosage of steroids to
reduce cerebral edema from anaplastic oligodendroglioma وَرَمُ الدِّبْقِيَّاتِ القَلِيْلَةِ التغَصُّن. A large
mass is seen in the right upper lobe, surrounded by a wide zone of
ground-glass attenuation (arrow) demonstrating the halo sign. A
smaller mass (arrowhead) is seen in the left lower lobe; it has indistinct
margins but no well-defined halo sign.
Transverse CT scan obtained in a 50-year-old woman with invasive
pulmonary aspergillosis treated with a high dosage of steroids to
reduce cerebral edema from anaplastic oligodendroglioma. A large
mass is seen in the right upper lobe, surrounded by a wide zone of
ground-glass attenuation (arrow) demonstrating the halo sign. A
smaller mass (arrowhead) is seen in the left lower lobe; it has indistinct
margins but no well-defined halo sign.
Transverse CT scan obtained in a 50-year-old woman with invasive
pulmonary aspergillosis treated with a high dosage of steroids to
reduce cerebral edema from anaplastic oligodendroglioma. A large
mass is seen in the right upper lobe, surrounded by a wide zone of
ground-glass attenuation (arrow) demonstrating the halo sign. A
smaller mass (arrowhead) is seen in the left lower lobe; it has indistinct
margins but no well-defined halo sign.
Transverse CT scan obtained in a 50-year-old woman with invasive
pulmonary aspergillosis treated with a high dosage of steroids to
reduce cerebral edema from anaplastic oligodendroglioma. A large
mass is seen in the right upper lobe, surrounded by a wide zone of
ground-glass attenuation (arrow) demonstrating the halo sign. A
smaller mass (arrowhead) is seen in the left lower lobe; it has indistinct
margins but no well-defined halo sign.
Transverse CT scan obtained in a 50-year-old woman with invasive
pulmonary aspergillosis treated with a high dosage of steroids to
reduce cerebral edema from anaplastic oligodendroglioma. A large
mass is seen in the right upper lobe, surrounded by a wide zone of
ground-glass attenuation (arrow) demonstrating the halo sign. A
smaller mass (arrowhead) is seen in the left lower lobe; it has indistinct
margins but no well-defined halo sign.
Transverse CT scan obtained in a 50-year-old woman with invasive
pulmonary aspergillosis treated with a high dosage of steroids to
reduce cerebral edema from anaplastic oligodendroglioma. A large
mass is seen in the right upper lobe, surrounded by a wide zone of
ground-glass attenuation (arrow) demonstrating the halo sign. A
smaller mass (arrowhead) is seen in the left lower lobe; it has indistinct
margins but no well-defined halo sign.
Transverse CT scan obtained in a 50-year-old woman with invasive
pulmonary aspergillosis treated with a high dosage of steroids to
reduce cerebral edema from anaplastic oligodendroglioma. A large
mass is seen in the right upper lobe, surrounded by a wide zone of
ground-glass attenuation (arrow) demonstrating the halo sign. A
smaller mass (arrowhead) is seen in the left lower lobe; it has indistinct
margins but no well-defined halo sign.
Transverse CT scan obtained in a 50-year-old woman with invasive
pulmonary aspergillosis treated with a high dosage of steroids to
reduce cerebral edema from anaplastic oligodendroglioma. A large
mass is seen in the right upper lobe, surrounded by a wide zone of
ground-glass attenuation (arrow) demonstrating the halo sign. A
smaller mass (arrowhead) is seen in the left lower lobe; it has indistinct
margins but no well-defined halo sign.
Transverse CT scan obtained in a 50-year-old woman with invasive
pulmonary aspergillosis treated with a high dosage of steroids to
reduce cerebral edema from anaplastic oligodendroglioma. A large
mass is seen in the right upper lobe, surrounded by a wide zone of
ground-glass attenuation (arrow) demonstrating the halo sign. A
smaller mass (arrowhead) is seen in the left lower lobe; it has indistinct
margins but no well-defined halo sign.
Transverse CT scan obtained in a 50-year-old woman with invasive
pulmonary aspergillosis treated with a high dosage of steroids to
reduce cerebral edema from anaplastic oligodendroglioma. A large
mass is seen in the right upper lobe, surrounded by a wide zone of
ground-glass attenuation (arrow) demonstrating the halo sign. A
smaller mass (arrowhead) is seen in the left lower lobe; it has indistinct
margins but no well-defined halo sign.
Invasive pulmonary aspergillosis in a 39-year-old man with acute myelogenous نقوي leukaemia and neutropenia. Thin-section CT at the level of the lung apex shows multiple nodules surrounded by a halo of ground glass opacity in both upper lobes.
CT halo sign: the spectrum of pulmonary diseases
Y R Lee, MD Y W Choi, MD K J Lee, MD S C Jeon, MD C K Park, MD and J-N Heo, MDDepartment of Diagnostic Radiology, College of Medicine, Hanyang University, 17 Haengdang-dong, Sungdong-gu, Seoul 133-792, Korea
Correspondence: Dr Yo Won Choi
Invasive pulmonary aspergillosis in a 39-year-old man with acute myelogenous leukaemia and neutropenia. Thin-section CT at the level of the lung apex shows multiple nodules surrounded by a halo of ground glass opacity in both upper lobes.
CT halo sign: the spectrum of pulmonary diseases
Y R Lee, MD Y W Choi, MD K J Lee, MD S C Jeon, MD C K Park, MD and J-N Heo, MDDepartment of Diagnostic Radiology, College of Medicine, Hanyang University, 17 Haengdang-dong, Sungdong-gu, Seoul 133-792, Korea
Correspondence: Dr Yo Won Choi
CT shows nodular consolidation associated with a halo of ground-glass opacity (GGO) in both apices resulting from invasive pulmonary aspergillosis.
This halo represents hemorrhage.
When seen in leukemic patients, is highly suggestive of the diagnosis of invasive pulmonary aspergillosis.
CT shows nodular consolidation associated with a halo of ground-glass opacity (GGO) in both apices resulting from invasive pulmonary aspergillosis.
This halo represents hemorrhage.
When seen in leukemic patients, is highly suggestive of the diagnosis of invasive pulmonary aspergillosis.
Cytomegalovirus pneumonia in a 45-year-old woman with rapidly progressive glomerulonephritis. Thin-section CT of the right lung base demonstrates multiple tiny nodules (arrows) with the CT halo sign in the right lower lobe.
CT halo sign: the spectrum of pulmonary diseases
Y R Lee, MD Y W Choi, MD K J Lee, MD S C Jeon, MD C K Park, MD and J-N Heo, MDDepartment of Diagnostic Radiology, College of Medicine, Hanyang University, 17 Haengdang-dong, Sungdong-gu, Seoul 133-792, Korea
Correspondence: Dr Yo Won Choi
Cytomegalovirus pneumonia in a 45-year-old woman with rapidly progressive glomerulonephritis. Thin-section CT of the right lung base demonstrates multiple tiny nodules (arrows) with the CT halo sign in the right lower lobe.
CT halo sign: the spectrum of pulmonary diseases
Y R Lee, MD Y W Choi, MD K J Lee, MD S C Jeon, MD C K Park, MD and J-N Heo, MDDepartment of Diagnostic Radiology, College of Medicine, Hanyang University, 17 Haengdang-dong, Sungdong-gu, Seoul 133-792, Korea
Correspondence: Dr Yo Won Choi
Cytomegalovirus pneumonia in a 45-year-old woman with rapidly progressive glomerulonephritis. Thin-section CT of the right lung base demonstrates multiple tiny nodules (arrows) with the CT halo sign in the right lower lobe.
CT halo sign: the spectrum of pulmonary diseases
Y R Lee, MD Y W Choi, MD K J Lee, MD S C Jeon, MD C K Park, MD and J-N Heo, MDDepartment of Diagnostic Radiology, College of Medicine, Hanyang University, 17 Haengdang-dong, Sungdong-gu, Seoul 133-792, Korea
Correspondence: Dr Yo Won Choi
Cytomegalovirus pneumonia in a 45-year-old woman with rapidly progressive glomerulonephritis. Thin-section CT of the right lung base demonstrates multiple tiny nodules (arrows) with the CT halo sign in the right lower lobe.
CT halo sign: the spectrum of pulmonary diseases
Y R Lee, MD Y W Choi, MD K J Lee, MD S C Jeon, MD C K Park, MD and J-N Heo, MDDepartment of Diagnostic Radiology, College of Medicine, Hanyang University, 17 Haengdang-dong, Sungdong-gu, Seoul 133-792, Korea
Correspondence: Dr Yo Won Choi
Kaposi sarcoma in a 29-year-old woman with a history of renal transplantation. Thin-section CT at the level of the carina shows multiple nodules with a surrounding halo of ground glass opacity in both lungs, which are dissimilar to flame-shaped lesions, the classic findings of Kaposi sarcoma.
Kaposi sarcoma in a 29-year-old woman with a history of renal transplantation. Thin-section CT at the level of the carina shows multiple nodules with a surrounding halo of ground glass opacity in both lungs, which are dissimilar to flame-shaped lesions, the classic findings of Kaposi sarcoma.
Kaposi sarcoma in a 29-year-old woman with a history of renal transplantation. Thin-section CT at the level of the carina shows multiple nodules with a surrounding halo of ground glass opacity in both lungs, which are dissimilar to flame-shaped lesions, the classic findings of Kaposi sarcoma.
Cytomegalovirus pneumonia in a 45-year-old woman with rapidly progressive glomerulonephritis. Thin-section CT of the right lung base demonstrates multiple tiny nodules (arrows) with the CT halo sign in the right lower lobe.
CT halo sign: the spectrum of pulmonary diseases
Y R Lee, MD Y W Choi, MD K J Lee, MD S C Jeon, MD C K Park, MD and J-N Heo, MDDepartment of Diagnostic Radiology, College of Medicine, Hanyang University, 17 Haengdang-dong, Sungdong-gu, Seoul 133-792, Korea
Correspondence: Dr Yo Won Choi
Cytomegalovirus pneumonia in a 45-year-old woman with rapidly progressive glomerulonephritis. Thin-section CT of the right lung base demonstrates multiple tiny nodules (arrows) with the CT halo sign in the right lower lobe.
CT halo sign: the spectrum of pulmonary diseases
Y R Lee, MD Y W Choi, MD K J Lee, MD S C Jeon, MD C K Park, MD and J-N Heo, MDDepartment of Diagnostic Radiology, College of Medicine, Hanyang University, 17 Haengdang-dong, Sungdong-gu, Seoul 133-792, Korea
Correspondence: Dr Yo Won Choi
Cytomegalovirus pneumonia in a 45-year-old woman with rapidly progressive glomerulonephritis. Thin-section CT of the right lung base demonstrates multiple tiny nodules (arrows) with the CT halo sign in the right lower lobe.
CT halo sign: the spectrum of pulmonary diseases
Y R Lee, MD Y W Choi, MD K J Lee, MD S C Jeon, MD C K Park, MD and J-N Heo, MDDepartment of Diagnostic Radiology, College of Medicine, Hanyang University, 17 Haengdang-dong, Sungdong-gu, Seoul 133-792, Korea
Correspondence: Dr Yo Won Choi
Cytomegalovirus pneumonia in a 45-year-old woman with rapidly progressive glomerulonephritis. Thin-section CT of the right lung base demonstrates multiple tiny nodules (arrows) with the CT halo sign in the right lower lobe.
CT halo sign: the spectrum of pulmonary diseases
Y R Lee, MD Y W Choi, MD K J Lee, MD S C Jeon, MD C K Park, MD and J-N Heo, MDDepartment of Diagnostic Radiology, College of Medicine, Hanyang University, 17 Haengdang-dong, Sungdong-gu, Seoul 133-792, Korea
Correspondence: Dr Yo Won Choi
Cytomegalovirus pneumonia in a 45-year-old woman with rapidly progressive glomerulonephritis. Thin-section CT of the right lung base demonstrates multiple tiny nodules (arrows) with the CT halo sign in the right lower lobe.
CT halo sign: the spectrum of pulmonary diseases
Y R Lee, MD Y W Choi, MD K J Lee, MD S C Jeon, MD C K Park, MD and J-N Heo, MDDepartment of Diagnostic Radiology, College of Medicine, Hanyang University, 17 Haengdang-dong, Sungdong-gu, Seoul 133-792, Korea
Correspondence: Dr Yo Won Choi
Eosinophilic Pneumonia
Eosinophilic lung disease may occur in various conditions, including parasitic infection, idiopathic pulmonary fibrosis, sarcoidosis, collagen vascular disease, hypereosinophilic syndrome, and drug reactions (39). Simple eosinophilic pneumonia (Loeffler syndrome) and idiopathic hypereosinophilic syndrome have been reported to produce nodular ground-glass opacity on thin-section CT images (Fig 11) (40). Histologically, ground-glass opacity represents intraalveolar exudates and fibrotic change with eosinophilic infiltration in the interstitium (41). In lesions with a central solid component, the solid portion corresponds histologically to a neutrophilic abscess (41).
Eosinophilic Pneumonia
Eosinophilic lung disease may occur in various conditions, including parasitic infection, idiopathic pulmonary fibrosis, sarcoidosis, collagen vascular disease, hypereosinophilic syndrome, and drug reactions (39). Simple eosinophilic pneumonia (Loeffler syndrome) and idiopathic hypereosinophilic syndrome have been reported to produce nodular ground-glass opacity on thin-section CT images (Fig 11) (40). Histologically, ground-glass opacity represents intraalveolar exudates and fibrotic change with eosinophilic infiltration in the interstitium (41). In lesions with a central solid component, the solid portion corresponds histologically to a neutrophilic abscess (41).
ground-glass opacity represents intraalveolar exudates and fibrotic change with eosinophilic infiltration in the interstitium (41). In lesions with a central solid component, the solid portion corresponds histologically to a neutrophilic abscess
ground-glass opacity represents intraalveolar exudates and fibrotic change with eosinophilic infiltration in the interstitium (41). In lesions with a central solid component, the solid portion corresponds histologically to a neutrophilic abscess
Wegener's granulomatosis in a 70-year-old woman. Thin-section CT shows a pulmonary nodule with the CT halo sign in the left lower lobe (thick arrow). Note another nodule in the right middle lobe but without surrounding ground glass opacity (thin arrow) (Courtesy of Kyung Soo Lee, MD, Samsung Medical Center, Seoul, Korea).
Wegener's granulomatosis in a 70-year-old woman. Thin-section CT shows a pulmonary nodule with the CT halo sign in the left lower lobe (thick arrow). Note another nodule in the right middle lobe but without surrounding ground glass opacity (thin arrow) (Courtesy of Kyung Soo Lee, MD, Samsung Medical Center, Seoul, Korea).
Wegener's granulomatosis in a 70-year-old woman. Thin-section CT shows a pulmonary nodule with the CT halo sign in the left lower lobe (thick arrow). Note another nodule in the right middle lobe but without surrounding ground glass opacity (thin arrow) (Courtesy of Kyung Soo Lee, MD, Samsung Medical Center, Seoul, Korea).
Wegener's granulomatosis in a 70-year-old woman. Thin-section CT shows a pulmonary nodule with the CT halo sign in the left lower lobe (thick arrow). Note another nodule in the right middle lobe but without surrounding ground glass opacity (thin arrow) (Courtesy of Kyung Soo Lee, MD, Samsung Medical Center, Seoul, Korea).
Eosinophilic Pneumonia
Eosinophilic lung disease may occur in various conditions, including parasitic infection, idiopathic pulmonary fibrosis, sarcoidosis, collagen vascular disease, hypereosinophilic syndrome, and drug reactions Simple eosinophilic pneumonia (Loeffler syndrome) and idiopathic hypereosinophilic syndrome have been reported to produce nodular ground-glass opacity on thin-section CT images (Histologically, ground-glass opacity represents intraalveolar exudates and fibrotic change with eosinophilic infiltration in the interstitium In lesions with a central solid component, the solid portion corresponds histologically to a neutrophilic abscess
Eosinophilic pneumonia in a 36-year-old man with peripheral blood eosinophilia. (a) Thin-section CT image at the level of the aortic arch shows an ill-defined area of nodular ground-glass opacity in the upper lobe of the right lung. (b) Thin-section CT image at the level of the upper lobar bronchus in the left lung shows a similar nodular ground-glass opacity.
Eosinophilic Pneumonia
Eosinophilic lung disease may occur in various conditions, including parasitic infection, idiopathic pulmonary fibrosis, sarcoidosis, collagen vascular disease, hypereosinophilic syndrome, and drug reactions Simple eosinophilic pneumonia (Loeffler syndrome) and idiopathic hypereosinophilic syndrome have been reported to produce nodular ground-glass opacity on thin-section CT images (Histologically, ground-glass opacity represents intraalveolar exudates and fibrotic change with eosinophilic infiltration in the interstitium In lesions with a central solid component, the solid portion corresponds histologically to a neutrophilic abscess
Eosinophilic pneumonia in a 36-year-old man with peripheral blood eosinophilia. (a) Thin-section CT image at the level of the aortic arch shows an ill-defined area of nodular ground-glass opacity in the upper lobe of the right lung. (b) Thin-section CT image at the level of the upper lobar bronchus in the left lung shows a similar nodular ground-glass opacity.
Eosinophilic Pneumonia
Eosinophilic lung disease may occur in various conditions, including parasitic infection, idiopathic pulmonary fibrosis, sarcoidosis, collagen vascular disease, hypereosinophilic syndrome, and drug reactions Simple eosinophilic pneumonia (Loeffler syndrome) and idiopathic hypereosinophilic syndrome have been reported to produce nodular ground-glass opacity on thin-section CT images (Histologically, ground-glass opacity represents intraalveolar exudates and fibrotic change with eosinophilic infiltration in the interstitium In lesions with a central solid component, the solid portion corresponds histologically to a neutrophilic abscess
Eosinophilic pneumonia in a 36-year-old man with peripheral blood eosinophilia. (a) Thin-section CT image at the level of the aortic arch shows an ill-defined area of nodular ground-glass opacity in the upper lobe of the right lung. (b) Thin-section CT image at the level of the upper lobar bronchus in the left lung shows a similar nodular ground-glass opacity.
Eosinophilic Pneumonia
Eosinophilic lung disease may occur in various conditions, including parasitic infection, idiopathic pulmonary fibrosis, sarcoidosis, collagen vascular disease, hypereosinophilic syndrome, and drug reactions Simple eosinophilic pneumonia (Loeffler syndrome) and idiopathic hypereosinophilic syndrome have been reported to produce nodular ground-glass opacity on thin-section CT images (Histologically, ground-glass opacity represents intraalveolar exudates and fibrotic change with eosinophilic infiltration in the interstitium In lesions with a central solid component, the solid portion corresponds histologically to a neutrophilic abscess
Eosinophilic pneumonia in a 36-year-old man with peripheral blood eosinophilia. (a) Thin-section CT image at the level of the aortic arch shows an ill-defined area of nodular ground-glass opacity in the upper lobe of the right lung. (b) Thin-section CT image at the level of the upper lobar bronchus in the left lung shows a similar nodular ground-glass opacity.
Thin-section CT image at the level of the upper lobar bronchus in the left lung shows a similar nodular ground-glass opacity.
Eosinophilic Pneumonia
Eosinophilic lung disease may occur in various conditions, including parasitic infection, idiopathic pulmonary fibrosis, sarcoidosis, collagen vascular disease, hypereosinophilic syndrome, and drug reactions Simple eosinophilic pneumonia (Loeffler syndrome) and idiopathic hypereosinophilic syndrome have been reported to produce nodular ground-glass opacity on thin-section CT images (Histologically, ground-glass opacity represents intraalveolar exudates and fibrotic change with eosinophilic infiltration in the interstitium In lesions with a central solid component, the solid portion corresponds histologically to a neutrophilic abscess
Eosinophilic pneumonia in a 36-year-old man with peripheral blood eosinophilia. (a) Thin-section CT image at the level of the aortic arch shows an ill-defined area of nodular ground-glass opacity in the upper lobe of the right lung. (b) Thin-section CT image at the level of the upper lobar bronchus in the left lung shows a similar nodular ground-glass opacity.
Thin-section CT image at the level of the upper lobar bronchus in the left lung shows a similar nodular ground-glass opacity.
Eosinophilic Pneumonia
Eosinophilic lung disease may occur in various conditions, including parasitic infection, idiopathic pulmonary fibrosis, sarcoidosis, collagen vascular disease, hypereosinophilic syndrome, and drug reactions Simple eosinophilic pneumonia (Loeffler syndrome) and idiopathic hypereosinophilic syndrome have been reported to produce nodular ground-glass opacity on thin-section CT images (Histologically, ground-glass opacity represents intraalveolar exudates and fibrotic change with eosinophilic infiltration in the interstitium In lesions with a central solid component, the solid portion corresponds histologically to a neutrophilic abscess
Eosinophilic pneumonia in a 36-year-old man with peripheral blood eosinophilia. (a) Thin-section CT image at the level of the aortic arch shows an ill-defined area of nodular ground-glass opacity in the upper lobe of the right lung. (b) Thin-section CT image at the level of the upper lobar bronchus in the left lung shows a similar nodular ground-glass opacity.
Thin-section CT image at the level of the upper lobar bronchus in the left lung shows a similar nodular ground-glass opacity.
Eosinophilic Pneumonia
Eosinophilic lung disease may occur in various conditions, including parasitic infection, idiopathic pulmonary fibrosis, sarcoidosis, collagen vascular disease, hypereosinophilic syndrome, and drug reactions Simple eosinophilic pneumonia (Loeffler syndrome) and idiopathic hypereosinophilic syndrome have been reported to produce nodular ground-glass opacity on thin-section CT images (Histologically, ground-glass opacity represents intraalveolar exudates and fibrotic change with eosinophilic infiltration in the interstitium In lesions with a central solid component, the solid portion corresponds histologically to a neutrophilic abscess
Eosinophilic pneumonia in a 36-year-old man with peripheral blood eosinophilia. (a) Thin-section CT image at the level of the aortic arch shows an ill-defined area of nodular ground-glass opacity in the upper lobe of the right lung. (b) Thin-section CT image at the level of the upper lobar bronchus in the left lung shows a similar nodular ground-glass opacity.
Thin-section CT image at the level of the upper lobar bronchus in the left lung shows a similar nodular ground-glass opacity.
Eosinophilic Pneumonia
Eosinophilic lung disease may occur in various conditions, including parasitic infection, idiopathic pulmonary fibrosis, sarcoidosis, collagen vascular disease, hypereosinophilic syndrome, and drug reactions Simple eosinophilic pneumonia (Loeffler syndrome) and idiopathic hypereosinophilic syndrome have been reported to produce nodular ground-glass opacity on thin-section CT images (Histologically, ground-glass opacity represents intraalveolar exudates and fibrotic change with eosinophilic infiltration in the interstitium In lesions with a central solid component, the solid portion corresponds histologically to a neutrophilic abscess
Eosinophilic pneumonia in a 36-year-old man with peripheral blood eosinophilia. (a) Thin-section CT image at the level of the aortic arch shows an ill-defined area of nodular ground-glass opacity in the upper lobe of the right lung. (b) Thin-section CT image at the level of the upper lobar bronchus in the left lung shows a similar nodular ground-glass opacity.
Thin-section CT image at the level of the upper lobar bronchus in the left lung shows a similar nodular ground-glass opacity.
Eosinophilic Pneumonia
Eosinophilic lung disease may occur in various conditions, including parasitic infection, idiopathic pulmonary fibrosis, sarcoidosis, collagen vascular disease, hypereosinophilic syndrome, and drug reactions Simple eosinophilic pneumonia (Loeffler syndrome) and idiopathic hypereosinophilic syndrome have been reported to produce nodular ground-glass opacity on thin-section CT images (Histologically, ground-glass opacity represents intraalveolar exudates and fibrotic change with eosinophilic infiltration in the interstitium In lesions with a central solid component, the solid portion corresponds histologically to a neutrophilic abscess
Eosinophilic pneumonia in a 36-year-old man with peripheral blood eosinophilia. (a) Thin-section CT image at the level of the aortic arch shows an ill-defined area of nodular ground-glass opacity in the upper lobe of the right lung. (b) Thin-section CT image at the level of the upper lobar bronchus in the left lung shows a similar nodular ground-glass opacity.
Thin-section CT image at the level of the upper lobar bronchus in the left lung shows a similar nodular ground-glass opacity.
Eosinophilic Pneumonia
Eosinophilic lung disease may occur in various conditions, including parasitic infection, idiopathic pulmonary fibrosis, sarcoidosis, collagen vascular disease, hypereosinophilic syndrome, and drug reactions Simple eosinophilic pneumonia (Loeffler syndrome) and idiopathic hypereosinophilic syndrome have been reported to produce nodular ground-glass opacity on thin-section CT images (Histologically, ground-glass opacity represents intraalveolar exudates and fibrotic change with eosinophilic infiltration in the interstitium In lesions with a central solid component, the solid portion corresponds histologically to a neutrophilic abscess
Eosinophilic pneumonia in a 36-year-old man with peripheral blood eosinophilia. (a) Thin-section CT image at the level of the aortic arch shows an ill-defined area of nodular ground-glass opacity in the upper lobe of the right lung. (b) Thin-section CT image at the level of the upper lobar bronchus in the left lung shows a similar nodular ground-glass opacity.
Wegener's granulomatosis in a 70-year-old woman. Thin-section CT shows a pulmonary nodule with the CT halo sign in the left lower lobe (thick arrow). Note another nodule in the right middle lobe but without surrounding ground glass opacity (thin arrow) (Courtesy of Kyung Soo Lee, MD, Samsung Medical Center, Seoul, Korea).
Wegener's granulomatosis in a 70-year-old woman. Thin-section CT shows a pulmonary nodule with the CT halo sign in the left lower lobe (thick arrow). Note another nodule in the right middle lobe but without surrounding ground glass opacity (thin arrow) (Courtesy of Kyung Soo Lee, MD, Samsung Medical Center, Seoul, Korea).
Wegener's granulomatosis in a 70-year-old woman. Thin-section CT shows a pulmonary nodule with the CT halo sign in the left lower lobe (thick arrow). Note another nodule in the right middle lobe but without surrounding ground glass opacity (thin arrow) (Courtesy of Kyung Soo Lee, MD, Samsung Medical Center, Seoul, Korea).
Wegener's granulomatosis in a 70-year-old woman. Thin-section CT shows a pulmonary nodule with the CT halo sign in the left lower lobe (thick arrow). Note another nodule in the right middle lobe but without surrounding ground glass opacity (thin arrow) (Courtesy of Kyung Soo Lee, MD, Samsung Medical Center, Seoul, Korea).
Wegener's granulomatosis in a 70-year-old woman. Thin-section CT shows a pulmonary nodule with the CT halo sign in the left lower lobe (thick arrow). Note another nodule in the right middle lobe but without surrounding ground glass opacity (thin arrow) (Courtesy of Kyung Soo Lee, MD, Samsung Medical Center, Seoul, Korea).
High-resolution CT scan of the chest shows bilateral nodular opacities with areas of patchy consolidation. Many nodules show central areas of ground glass opacity, with surrounding consolidation.
High-resolution CT scan of the chest shows bilateral nodular opacities with areas of patchy consolidation. Many nodules show central areas of ground glass opacity, with surrounding consolidation.