Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
권호 표지

Cytomegalovirus Pneumonia: High-Resolution CT Findings in Ten Non-AIDS Immunocompromised Patients

  • Jeung Hee Moon (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Eun A Kim (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kyung Soo Lee (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Tae Sung Kim (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kyung-Jae Jung (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jae-Hoon Song (Division of Infectious Disease, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2000.02.24
  • Accepted : 2000.05.18
  • Published : 2000.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: To describe the HRCT findings of cytomegalovirus (CMV) pneumonia in non-AIDS immunocompromised patients Materials and Methods: This retrospective study involved the ten all non-AIDS immunocompromised patients with biopsy-proven CMV pneumonia and without other pulmonary infection encountered at our Medical Center between January 1997 and May 1999. HRCT scans were retrospectively analysed by two chest radiologists and decisions regarding the findings were reached by consensus. Results: The most frequent CT pattern was ground-glass opacity, seen in all patients, with bilateral patchy (n = 8) and diffuse (n = 2) distribution. Other findings included poorly-defined small nodules (n = 9) and consolidation (n = 7). There was no zonal predominance. The small nodules, bilateral in eight cases and unilateral in one, were all located in the centrilobular region. Consolidation (n = 7), with patchy distribution, was bilateral in five of seven patients (71%). Pleural effusion and bilateral areas of thickened interlobular septa were seen in six patients (60%). Conclusion: CMV pneumonia in non-AIDS immunocompromised patients appears on HRCT scans as bilateral mixed areas of ground-glass opacity, poorly-defined centrilobular small nodules, and consolidation. Interlobular septal thickening and pleural effusion are frequently associated.

Keywords

References

  1. Rubin RH, Cosimi AB, Tolkoff-Rubin NE, Russel PS, Hirsch MS. Infectious disease syndromes attributable to cytomegalovirus and their significance among renal transplantation recipients. Transplantation 1977;24:458-464  https://doi.org/10.1097/00007890-197712000-00010
  2. Abdallah PS, Mark JBD, Merigan TC. Diagnosis of cytomegalovirus pneumonia in compromised hosts. Am J Med 1976;61:326-332  https://doi.org/10.1016/0002-9343(76)90368-5
  3. Ravin CE, Smith GW, Ahern MJ, et al. Cytomegaloviral infection presenting as a solitary pulmonary nodule. Chest 1977;71:220-222  https://doi.org/10.1378/chest.71.2.220
  4. Krowka MJ, Rosenow EC, Hoagland HC. Pulmonary complications of bone marrow transplantation. Chest 1985;87:237-246  https://doi.org/10.1378/chest.87.2.237
  5. Schulman LL. Cytomegalovirus pneumonitis and lobar consolidation. Chest 1987;91:558-561  https://doi.org/10.1378/chest.91.4.558
  6. Klotman ME, Hamilton JD. Cytomegalovirus pneumonia. Semin Respir Infect 1987;2:95-103 
  7. Wallace JM, Hannah J. Cytomegalovirus pneumonitis in patients with AIDS. Findings in an autopsy series. Chest 1987;92:198-203  https://doi.org/10.1378/chest.92.2.198
  8. Johnson PC, Hogg KM, Sarosi GA. The rapid diagnosis of pulmonary infections in solid organ transplant recipients. Semin Respir Infect 1990;5:2-9 
  9. McGuinness G, Scholes JV, Garay SM, Leitman BS, McCauley DI, Naidich DP. Cytomegalovirus pneumonitis: spectrum of parenchymal CT findings with pathologic correlation in 21 AIDS patients. Radiology 1994;192:451-459  https://doi.org/10.1148/radiology.192.2.8029414
  10. Aafedt BC, Halvorsen RA, Tylen U, Hertz M. Cytomegalovirus pneumonia: computed tomography findings. J Can Assoc Radiol 1990;41:276-280 
  11. Northfelt DW, Sollitto RA, Miller TR, Hollander H. Cytomegalovirus pneumonitis. An unusual cause of pulmonary nodule in a patient with AIDS. Chest 1993;103:1918-1920  https://doi.org/10.1378/chest.103.6.1918
  12. Berger LA. Imaging in the diagnosis of infections in immunocompromised patients. Curr Opin Infect Dis 1998;11:431-436  https://doi.org/10.1097/00001432-199808000-00006
  13. Austin JH, Schulman LL, Mastrobattista JD. Pulmonary infection after cardiac transplantation: clinical and radiologic correlations. Radiology 1998;72:259-265  https://doi.org/10.1148/radiology.172.1.2544923
  14. Shreeniwas R, Schulman LL, Berkmen YM, McGregor CC, Austin JHM. Opportunistic bronchopulmonary infections after lung transplantation: clinical and radiographic findings. Radiology 1996;200:349-356  https://doi.org/10.1148/radiology.200.2.8685324
  15. Afessa B, Gay PC, Plevak DJ, et al. Pulmonary complications of orthotopic liver transplantation. Mayo Clin Proc 1993;68:427-434  https://doi.org/10.1016/S0025-6196(12)60187-6
  16. Kang EY, Patz EF, Muller NL. Cytomegalovirus pneumonia in transplant patients: CT findings. J Comput Assist Tomogr 1996;20:295-299  https://doi.org/10.1097/00004728-199603000-00024
  17. Zantel J, Leij L, Prop J, Harmsen MC. The Human cytomegalovirus: a viral complication in transplantation. Clin Transplant 1998;12:145-158 
  18. Moore EH, Webb WR, Amend WJC. Pulmonary infections in renal transplantation patients treated with cyclosporine. Radiology 1988;167:97-103  https://doi.org/10.1148/radiology.167.1.2831565
  19. Leung AN, Grosselin MV, Napper CH, et al. Pulmonary infections after bone marrow transplantation: clinical and radiographic findings. Radiology 1999;210:699-710  https://doi.org/10.1148/radiology.210.3.r99mr39699
  20. Husni RN, Gordon SM, Longworth DL, et al. Cytomegalovirus infection is a risk factor for invasive aspergillosis in lung transplant recipients. Clin Infect Dis 1998;26:753-755  https://doi.org/10.1086/514599
  21. Chien J, Chan CK, Chamberlain D, et al. Cytomegalovirus pneumonia in allogeneic bone marrow transplantation. An immunopathologic process? Chest 1990;98:1034-1037  https://doi.org/10.1378/chest.98.4.1034
  22. Worthy SA, Flint JD, Muller NL. Pulmonary complications after bone marrow transplantation: high-resolution CT and pathologic findings. RadioGraphics 1997;17:1395-1371 
  23. Aukrust P, Farstad IN, Froland SS, Holter E. Cytomegalovirus (CMV) pneumonitis in AIDS patients: the result of intensive CMV replication? Eur Respir J 1992;5:362-364  https://doi.org/10.1183/09031936.93.05030362
  24. KIM HS, LEE JS. Cytomegalovirus pneumonia in immunocompromised patients: HRCT findings. J Korean Radiol Soc 1999;41:1133-1138 https://doi.org/10.3348/jkrs.1999.41.6.1133