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Ct halo sign (part 1)
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)
- 2. Topic Outline 1. CThalo sign (part 1) 2
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- 5. CT halo sign Refersto a zone of ground-glass attenuation (the halo) surrounding a pulmonary nodule or mass or consolidation 5
- 6. HRCT of thorax CThalo sign Nodular Ground-Glass Opacity 6
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- 10. Halo sign couldbe 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 couldbe 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
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- 14. Aspergillosis • Aspergillosis maybe manifested as areas of nodular ground- glass opacity 14 http://radiographics.rsna.org/content/27/2/391.full
- 15. Photomicrograph of ahistologic 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
- 16. High-power photomicrograph (originalmagnification, ×1000; hematoxylin-eosin stain) shows fungal hyphae. 17 http://radiographics.rsna.org/content/27/2/391/F25.expansion.html
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- 18. High-power photomicrograph (originalmagnification, ×1000; hematoxylin-eosin stain) shows fungal hyphae. 19 http://radiographics.rsna.org/content/27/2/391/F25.expansion.html
- 19. The clinicopathologic featuresand radiologic manifestations of aspergillosis depend on • Patient immunity 20 http://radiographics.rsna.org/content/27/2/391.full
- 20. The clinicopathologic featuresand 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 featuresand 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-oldwoman treated with a high dosage of steroids to reduce cerebral edema from anaplastic oligodendroglioma ِةَلْيِلَقالنُّصَغالت ُمَرَوِتاَّيِقْبِالد 23
- 23. Invasive Pulmonary Aspergillosis • Alarge mass is seen in : A. The RUL B. The Middle lobe C. The RLL 24
- 24. Invasive Pulmonary Aspergillosis • Alarge mass is seen in : A. The RUL B. The Middle lobe C. The RLL 25
- 25. Invasive Pulmonary Aspergillosis • Alarge mass is seen in RUL localized in: A. Apical Segment B. Posterior Segment C. Anterior Segment 26
- 26. Invasive Pulmonary Aspergillosis • Alarge mass is seen in RUL localized in: A. Apical Segment B. Posterior Segment C. Anterior Segment 27
- 27. Invasive Pulmonary Aspergillosis • Alarge 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
- 28. Invasive Pulmonary Aspergillosis • Asmaller mass (arrowhead) is seen in: A. The LLL. B. The LUL. 29
- 29. Invasive Pulmonary Aspergillosis • Asmaller mass (arrowhead) is seen in: A. The LLL. B. The LUL. 30
- 30. Invasive Pulmonary Aspergillosis • Asmaller mass (arrowhead) is seen in LLL: A. Superior Segment B. Lateral Basal Segment C. Posterior Basal Segment 31
- 31. Invasive Pulmonary Aspergillosis • Asmaller mass (arrowhead) is seen in LLL: A. Superior Segment B. Lateral Basal Segment C. Posterior Basal Segment 32
- 32. Case • A 39-year-oldman with acute myelogenous leukaemia and neutropenia 33 http://bjr.birjournals.org/cgi/content/full/78/933/862#T1
- 33. Thin-section CT atthe 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 showsnodular consolidation associated with a halo of ground-glass opacity (GGO) in both apices resulting from invasive pulmonary aspergillosis 35
- 35. • This halorepresents hemorrhage. • When seen in leukemic patients, is highly suggestive of the diagnosis of invasive pulmonary aspergillosis. 36
- 36. Case • A 45-year-old womanwith 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 ofthe 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 patienthas 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 patienthas 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
- 40.
- 41. Kaposi sarcoma ina 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 ina 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 ina 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-sectionCT 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-sectionCT 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 pulmonarynodule with the CT halo sign 47 http://bjr.birjournals.org/cgi/content-nw/full/78/933/862/F4
- 47. What diagnosis thatdo 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 thatdo 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
- 49.
- 50. Eosinophilic Pneumonia Eosinophilic lung diseasemay 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.
- 52. Histologically Ground-glass opacity Intraalveolar exudates Fibrotic change Eosinophilic infiltration in theinterstitium 53 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.
- 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 • Showsmultiple 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 thatdo 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 thatdo 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 (Loefflersyndrome) • 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 imageat the level of the aortic arch 59 http://radiographics.rsna.org/content/27/2/391/F26.expansion.html
- 59. An ill-defined areaof 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 thatdo 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 thatdo 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
- 62.
- 63. Quiz Ground-glass opacity atthe 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 atthe 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 atthe 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 atthe 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
- 67.
- 68.
- 69. Case • Thin-section CT showsa 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 nodulein 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 nodulein 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 thatdo 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 thatdo 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
- 74.
- 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
- #2 A Pictorial Review of “Signs in Thoracic Imaging” Karuppasamy, K.1, Abhyankar-Gupta, M.1, Fewins, H.1, Curtis, J.2 1The Cardiothoracic Centre - Liverpool NHS Trust, 2Aintree University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
- #6 Refers to a zone of ground-glass attenuation (the halo) surrounding a pulmonary nodule or mass or consolidation
- #15 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.
- #16 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.
- #17 Photomicrograph of a histologic specimen (original magnification, ×100; hematoxylin-eosin stain) shows an aspergillus colony (arrows) and a surrounding area of intraalveolar hemorrhage (arrowheads).
- #18 High-power photomicrograph (original magnification, ×1000; hematoxylin-eosin stain) shows fungal hyphae خيطان.
- #19 High-power photomicrograph (original magnification, ×1000; hematoxylin-eosin stain) shows fungal hyphae خيطان.
- #20 High-power photomicrograph (original magnification, ×1000; hematoxylin-eosin stain) shows fungal hyphae خيطان.
- #21 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.
- #22 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.
- #23 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.
- #24 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.
- #25 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.
- #26 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.
- #27 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.
- #28 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.
- #29 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.
- #30 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.
- #31 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.
- #32 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.
- #33 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.
- #34 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
- #35 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
- #36 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.
- #37 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.
- #38 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
- #39 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
- #40 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
- #41 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
- #43 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.
- #44 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.
- #45 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.
- #46 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
- #47 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
- #48 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
- #49 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
- #50 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
- #52 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).
- #53 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).
- #54 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
- #55 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
- #56 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).
- #57 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).
- #58 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).
- #59 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).
- #60 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.
- #61 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.
- #62 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.
- #63 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.
- #65 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.
- #66 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.
- #67 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.
- #68 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.
- #69 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.
- #70 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.
- #71 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).
- #72 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).
- #73 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).
- #74 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).
- #75 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).
- #77 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.
- #78 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.