Eosinophilic lung diseases are a diverse group of pulmonary disorders associated with peripheral or tissue eosinophilia. They are classified as eosinophilic lung diseases of unknown cause (simple pulmonary eosinophilia [SPE], acute eosinophilic pneumonia [AEP], chronic eosinophilic pneumonia [CEP], idiopathic hypereosinophilic syndrome [IHS]), eosinophilic lung diseases of known cause (allergic bronchopulmonary aspergillosis [ABPA], bronchocentric granulomatosis [BG], parasitic infections, drug reactions), and eosinophilic vasculitis (allergic angiitis, granulomatosis [Churg-Strauss syndrome]). The percentages of eosinophils in peripheral blood and bronchoalveolar lavage fluid are essential parts of the evaluation. Chest computed tomography (CT) demonstrates a more characteristic pattern and distribution of parenchymal opacities than does conventional chest radiography. At CT, SPE and IHS are characterized by single or multiple nodules with a surrounding ground-glass-opacity halo, AEP mimics radiologically hydrostatic pulmonary edema, and CEP is characterized by nonsegmental airspace consolidations with peripheral predominance. ABPA manifests with bilateral central bronchiectasis with or without mucoid impaction. The CT manifestations of BG are nonspecific and consist of a focal mass or lobar consolidation with atelectasis. The most common CT findings in Churg-Strauss syndrome include sub-pleural consolidation with lobular distribution, centrilobular nodules, bronchial wall thickening, and interlobular septal thickening. The integration of clinical, radiologic, and pathologic findings facilitates the initial and differential diagnoses of various eosinophilic lung diseases.

Advanced insights into the pathophysiology and imaging features of COVID-19 along with vaccine benefits have improved patient care, but emerging knowledge of post–COVID-19 condition (long COVID) al... COVID-19 has emerged as a pandemic leading to a global public health crisis of unprecedented morbidity. A comprehensive insight into the imaging of COVID-19 has enabled early diagnosis, stratificat...

Vaccinated patients with COVID-19 breakthrough infections showed fewer chest CT findings of pneumonia compared to unvaccinated patients. Background Since vaccines against coronavirus disease 2019 (COVID-19) became available, rare breakthrough infections have been reported despite their high efficacies. Purpose To evaluate the clinic...

The prevalence of CT interstitial lung abnormalities (ILAs) in an Asian health screening cohort was approximately 3%, and fibrotic ILA was independently associated with imaging progression, lung ca... Background The association between interstitial lung abnormalities (ILAs) and long-term outcomes has not been reported in Asian health screening populations. Purpose To investigate ILA prevalence i...

Background: Mediastinitis remains a life-threatening disease that is difficult to manage and has a poor prognosis. This is especially true of descending necrotizing mediastinitis, which before the 1990s era had a mortality of approximately 40% despite the use of antibiotics, surgical techniques, and intensive care monitoring. Several authors have recommended that aggressive surgical approaches for mediastinitis are more effective than simple surgical approaches; however the best surgical option for mediastinitis remains controversial. Materials and methods: In a retrospective analysis between January 2000 and June 2006, 17 patients who underwent surgical debridement and drainage using video-assisted thoracoscopic surgery are included in this report. Data extracted from medical records included sex, age, origin of infection, surgical intervention, progress, and outcome including cause of death. There were eight men and nine women. The mean age was 52 years old (range, 20–72). Results: The origins of infection included esophageal perforation in nine patients and odontogenic or peritonsillar abscesses in the remaining eight patients. Among them, two patients required conversion to thoracotomy during operation in cases of mediastinitis due to esophageal perforation, so excluding the two patients, we calculated next five data for 15 patients. The mean duration from onset of symptoms to surgery was 12.4 ± 13.1 days (range, 0–43) and the mean duration from the initial operation to discharge was 43.6 ± 24.4 days (range, 8–113). There was serial operation in one case. There were three cases of postoperative mortality. Conclusion: Mediastinal drainage using video-assisted thoracoscopic surgery with or without cervical drainage can be a feasible and effective surgical option. This less invasive technique seems to have an outcome similar to more aggressive open surgical approaches for patients with mediastinitis previously reported in the literature, although it has not been directly compared.

Background Preoperative localization with lipiodol for identifying small or deeply seated pulmonary nodules is simple and useful for thoracoscopic surgery. Although several studies about performance and complication rates of lipiodol localization have been reported, there has been no report about the performance and complication rates of lipiodol localization with regard to the CT appearance of pulmonary nodules. Purpose To evaluate the performance and complication rates of localization of pulmonary nodules with lipiodol prior to video-assisted thoracoscopic surgery with regard to the CT appearance of nodules. Material and Methods After institutional review board approval and informed consent were obtained, lipiodol marking was performed in 67 patients (33 men and 34 women; mean age 58 years) with 68 nodules. All nodules were marked with 0.4–0.5 mL lipiodol under CT guidance on the day of surgery. The size of the targeted nodule and the shortest distance to the accessible pleural surface were measured. Lipiodol accumulation of a targeted nodule was scored by use of a four-point scale (0: none, 1: within 1 cm around a nodule, 2: partial accumulation within a nodule, 3: total accumulation within a nodule). Any complications after localization of nodules were noted. We analyzed the score of lipiodol accumulation and the presence of complications for the CT appearance of pulmonary nodules using the Mann Whitney U test, Fisher's exact test and the Kruskall Walis test. Results The average nodule size was 11.4 mm (range 3.0–28.3 mm) and the average distance to the pleural surface was 13.7 mm (range 0–51.4 mm). Lipiodol accumulation scores of nodules were as follows: score 3 (n = 19, 28%), score 2 (n = 37, 54%), score 1 (n = 11, 16%), and score 0 (n = 1, 2%). Lipiodol accumulation scores of nodules were different according to the size of nodules (Kruskal Wallis test, p = 0.023). Pneumothorax after localization occurred in 20 (29%) patients and the incidence was higher in nodules located in the subpleural area (Mann Whitney U test, p = 0.048). Pulmonary hemorrhage along the needle tract occurred in five (7%) patients and was more frequent in patients with deep nodules as compared to shallow nodules (Mann Whitney U test, p < 0.001). Conclusion Lipiodol marking under CT guidance is a useful and safe procedure for the intraoperative localization of pulmonary nodules. Of variable CT findings, lesion size is important to determine the degree of lipiodol accumulation and the lesion depth is the most important feature for the development of postprocedural complications.