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흉부영상의학회 월례집담회. 2015-11-19 서울아산병원 구현정. Case 2. C.C. General weakness S/P LDLT for alcoholic liver cirrhosis, HCC. 2015-9-17. 2015-9-21. 2015-9-22. 2015-9-22. * 온 몸에 다발성 발진 ( 얼굴 , 등 , 배 , 일부 vesicular, pustules). 2015-9-21. 2015-9-28. 2015-9-30. 2015-9-30. Clinical Course.
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흉부영상의학회월례집담회 2015-11-19 서울아산병원 구현정
Case 2 C.C. Generalweakness S/P LDLT for alcoholic liver cirrhosis, HCC
* 온 몸에 다발성 발진 (얼굴, 등, 배, 일부 vesicular, pustules)
2015-9-21 2015-9-28
Clinical Course Clinical information: Alcoholic LC, HCC로 2015-4-21 LDLT시행하고 follow-up 중이던 분으로, poor oral intake로 입원 중 fever발생해 시행한 radiograph에서 abnormal소견 있어 CT시행 2015-9-25 CT 1. Diffuse interstitial thickening with centrilobular tiny nodules in both lungs GGO foci in the BULs. Increased the extent in short period c/w herpex zoster infection r/o other atypical pneumonia, especially in BULs such as viral r/o lymphangiticcarcinomatosis * 온 몸에 다발성 발진(얼굴, 등, 배, 일부 vesicular, pustules) Diagnosis Skin, (abdomen), punch biopsy: Herpes viral infection
Varicella-Zoster Pneumonia • 1. Introduction • Varicella zoster virus: a type of herpes virus that causes chicken pox or zoster • Varicella zoster pneumonia • : most serious complication of disseminated varicella-zoster infection • mortality rates: 9 – 50% • incidence: 5 – 50 % of all varicella infection in adults • more than 90% of cases occur in immunocompromised patients • symptoms develops within a few days after skin rash appears • References • Kim JS, Ryu CW, Lee SI et al. High-Resolution CT findings of Varicella-Zoster Pneumonia. AJR 1999;172:1 13-166. • Maher TM, Gupta NK, Burke MM et al. CT findings of Varicella Pneumonia After Lung Transplantation. AJR 2007 188:W557-559. • Kim EA, Lee KS, Primack SL et al. Viral Pneumonias in Adults: Radiologic and Pathologic Findings. Radiographics 2002;22:S137-149.
Varicella-Zoster Pneumonia • 2. Radiologic findings • Diffuse multiple small (5-10mm) ill-defined nodules • Nodules with surrounding halo of ground glass opacity • Nodules may be confluent • Hilar lymphadenopathy (uncommon) • Small pleural effusion (uncommon) • 3. Histopathology • Nodules are composed of lamellated fibrous capsule enclosing areas of hyalinized collagen or necrotic tissue