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Excerpts from RSNA Case-based Review of Thoracic Radiology (An Interactive Session)- Part 1

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Webinar :Case-based Review of Thoracic Radiology (An Interactive Session) 

This was part of RSNA 2017 virtual meeting. I am writing down the salient points from this excellent lecture:

Paediatric chest:

  • Congenital immunodeficiency syndromes:

    • Chronic Granulomatous Disease:

      • Inability to kill catalase positive organisms like staphylococcus and aspergillus.
      • Early manifestations: Miliary nodules, abscess, pneumonia, empyema.
      • Late manifestations: bronchiectasis and pulmonary fibrosis.
    • Leukocyte adhesion deficiency type I.

      • Presents in infants as bacterial infection.
      • Affects mucosa and skin.
      • No pus formation.
    • G6PD deficiency

      • May present with infections similar that of CGD.
      • Haemolytic anaemia on consumption of fava beans or medications.
    • Myeloperoxidase deficiency

      • Typically occurs in patients with diabetes.
      • Most common infection is Candida.

 

  • Cardiac tumours.

    • Rhabdomyoma:

      • Paediatric chest x-ray showing cardiomegaly.
      • The most common primary cardiac tumour in children.
      • It is associated with the ventricular myocardium and appears homogeneously hyperintense on T2-weighted images.
      • 50 to 70% are associated with tuberous sclerosis.
      • Spontaneous regression is common.
      • Tuberous sclerosis can have pulmonary manifestations in the form of
        • LAM (lymphangioleiomyomatosis): Uniform sized cysts.
        • Multifocal micronodular pneumocyte hyperplasia (MMPH):  multiple well-defined nodules. Image on AJNR : MMPH. Article : MMPH
Fetal Cardiac Rhabdomyoma
Fetal Cardiac Rhabdomyoma

Case courtesy of Dr Effendi Mansoor, <a href=”https://radiopaedia.org/”>Radiopaedia.org</a>. From the case <a href=”https://radiopaedia.org/cases/17302″>rID: 17302</a>

    • Fibroma:

      • 2nd MC
      • Free wall of ventricle
      • Associated with Gorlin Syndrome.
    • Myxoma:

      • 3rd MC
      • Pedunculated. Interatrial septum.
      • Asso with Carney complex: Hyperpigmentation and endocrine overactivity
    • Teratoma:

      • Within pericardium
      • Pericardial effusion.
      • Heterogenous with fat/calcification.
  • Sickle Cell disease:

    • Dactylitis.

      • 6m-3y
      • Soft tissue swelling.
      • Periosteal reaction.
      • Cortical disruption.
      • Spontaneous improvement.
    • Chest syndorme.

      • New opacity.
      • Increased pulmonary vasculature.
      • Cardiomegaly.
  • Langerhans Cell Histiocytosis:

    • Early: Nodules with small cysts. Spontaenous pneumothorax.
    • Advanced: Large cysts with pulmonary fibrosis.
    • Can involve bones as well.
  • Wegner’s granulomatosis:

 

Part 2 here:

 

 

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