A pictorial review of “signs in thoracic imaging 01”

Air bronchogram sign
Air crescent sign

1. A Pictorial Review of “Signs in Thoracic Imaging ” Part 01 Dr Mazen Qusaibaty MD, DIS Head Pulmonary and Internist Department Ibnalnafisse Hospital Ministry of Syrian health Email: [email protected]

2. Topic Outline Air bronchogram sign Air crescent sign 2

3. Air bronchogram sign علامة الارتسام القصبي الهوائي 3

4. Air bronchogram sign علامة الارتسام القصبي الهوائي هي القدرة على مشاهدة الحدود القصبية ضمن المتن الرئوي المصاب بحديثة مرضية تقيحية (قيح) أو وذمية ( ماء) ذات الرئة. 4

5. Air bronchogram sign RUL Consolidation Sterp Pneumonia 5

6. Air bronchogram sign Pneumococcal pneumonia Consolidation with multiple air bronchograms ( black branching structures) in the: RUL RML RLL 6

7. Air bronchogram sign Pneumococcal pneumonia Consolidation with multiple air bronchograms in the: Segment anterior of RUL RML RLL 7

8. Air bronchogram sign Diffuse Alveolar Hemorrhage 8

9. 9 Air bronchogram sign Acute eosinophilic pneumonia

10. Air Bronchogram Sign DD: Pneumonia Lymphoma Bronchoalveolar cell carcinoma.

11. Conclusion: Air bronchogram 11

12. 12 Air crescent sign علامة الهلال الغازي

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15. Air crescent sign علامة الهلال الغازي The air surrounding a radio opaque material 15

16. Air crescent sign علامة الهلال الغازي In a crescentric manner along both its inner and outer margins indicating cavitary disease 16

17. Air crescent sign علامة الهلال الغازي Aspergilloma in an old TB cavity 17

18. The arrows denote an ill-defined nodular opacity in medial aspect of right upper lobe with ill-defined rim of lucency surrounding it. 18

19. Invasive aspergillosis in a 6-year-old girl with neutropenia and acute lymphocytic leukemia 19

20. Frontal chest radiograph shows two air crescent signs (arrowheads) 20

21. Chest roentgenogram PA view 21

22. Computed tomogram of the thorax Various views of the mycetoma Rupture into the pleural cavity leading to pneumothorax 22

23. Coronal reformation image Intracavitary aspergilloma (*) in the left upper lobe 23

24. Air crescent –shaped surrounding oval opacity within cavity 24 Subpleural honeycombing in the lower lobes consistent with idiopathic pulmonary fibrosis .

25. What is your diagnosis? The patient was a 58-year-old man with previous tuberculosis and intracavitary aspergilloma 25

26. Sagittal reformat from a CT scan of the chest 26 A 14 year-old female with acute myeloblastic leukaemia

27. Where is located this lesion? 27 Left Lung Right Lung

28. Where is located this lesion? 28 Left Lung Apical segment of Right Upper Lobe in lateral position

29. Correct description A Mycetoma with air-crescent sign located in apical segment of right upper lobe in lateral position 29

30. Air crescent sign in anterior segment of right upper lobe Aspergilloma 30

31. PA Projection radiograph 31 Patchy airspace disease with areas of lucency suggestive of cavitation in the right upper lobe.

32. PA Projection radiograph 32 Emphysematous changes are seen bilaterally.

33. Chest CT scan Air crescent sign within the consolidated right upper lobe. 33

34. Chest CT scan Paraseptal emphysema 34

35. Chest CT scan A cavity with an intracavitary mass within the consolidated right upper lobe 35

36. Conclusion: Air crescent sign indicates a lung cavity, often due to fungal infection 36