Imaging
Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary, Critical Care & Sleep publishes case-based articles with characteristic chest imaging and related pathology.
The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend. Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary, Critical Care & Sleep publishes case-based articles with characteristic chest imaging and related pathology. The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend.
May 2015 Imaging Case of the Month
Michael B. Gotway, MD
Department of Radiology
Mayo Clinic Arizona
Scottsdale, AZ
Clinical History: A 66 year-old woman presented with a history of hypothyroidism on replacement therapy, and a past medical history of pancreatitis, presented to her gastroenterologist with complaints of abdominal pain and loose stools. The episodes of pancreatitis began over a decade earlier with epigastric pain that was ultimately attributed to cholecystitis, for which endoscopic retrograde cholangiopancreatography (ERCP) was performed; this procedure precipitated her first episode of pancreatitis. During the ERCP procedure, her common bile duct was noted to be narrowed and several stones were removed, with placement of a stent, after which her epigastric pain resolved. A second stent placement procedure was required for recurrent epigastric pain approximately three weeks later, with good result.
Nearly a decade later, the patient presented with loose stools and fecal urgency associated with abdominal pain. Upper endoscopy showed mild gastric erosions (the patient was taking non-steroidal anti-inflammatory agents for intermittent back pain) and colonoscopy showed mild, non-specific colitis. The paint was diagnosed with pancreatic insufficiency and enzyme replacement therapy was begun, with symptomatic improvement.
During the course of her gastrointestinal consult, a frontal chest radiograph (Figure 1) was performed.
Figure 1. Frontal chest radiograph.
Which of the following statements regarding the chest radiograph is most accurate? (Click on the correct answer to proceed to the second of nine panels)
Reference as: Gotway MB. May 2015 imaging case of the month. Southwest J Pulm Crit Care. 2015;10(5):223-34. doi: http://dx.doi.org/10.13175/swjpcc070-15 PDF