J Korean Radiol Soc.  1998 Dec;39(6):1125-1130. 10.3348/jkrs.1998.39.6.1125.

Radiologic Findings of Diffuse Pulmonary Hemorrhage

Affiliations
  • 1Department of Diagnostic Radiology, University of Ulsan, College of Medicine.

Abstract

PURPOSE: To describe the chest radiographic and CT findings of diffuse pulmonary hemorrhage.
MATERIALS AND METHODS
Two radiologists retrospectively analysed the chest radiographic and CT findings of six patients withdiffuse pulmonary hemorrhage. Using open lung biopsy (n=2) and transbronchial lung biopsy or bronchoalveolarlavage (n=4), diagnosis was based on the presence of hemosiderin-laden macrophage or intra-alveolar hemorrhage.Underlying diseases were Wegener's granulomatosis (n=2), antiphospholipid antibody syndrome (n=2),Henoch-Schonlein purpura (n=1), and idopathic pulmonary hemosiderosis (n=1). In all patients, sequential chestradiographs, obtained during a one to six-month period, were available. HRCT scans were obtained in five patients,and conventional CT scans in one. Follow-up HRCT scans were obtained in two. We also analyzed the patterns ofinvolvement, distribution and sequential changes in the pulmonary abnormalities seen on chest radiographs and CTscans.
RESULTS
Chest radiographs showed multifocal patchy consolidation (n=6), ground-glass opacity (n=3), andmultiple granular or nodular opacity (n=3). These lesions were intermingled in five patients, while in one therewas consolidation only. Sequential chest radiographs demonstrated the improvement of initial pulmonaryabnormalities and appearance of new lesions elsewhere within 5-6 days, though within 7-25 (average, 13) days,these had almost normalized. HRCT scans showed patchy consolidation (n=5), multiple patchy ground-glass opacity(n=5), or ill-defined air space nodules (n=4). These lesions were intermingled in five patients, and in one,ground-glass opacity only was noted. In two patients there were interlobular septal thickening and intralobularreticular opacity. The distribution of these abnormalities was almost always bilateral, diffuse with no zonalpredominancy , and spared the apex of the lung and subpleural region were less affected.
CONCLUSION
Althoughchest radiographic and CT findings of diffuse pulmonary hemorrhage are nonspecific, sequential changes inbilateral multifocal patchy consolidation and ground-glass opacity, accompanied by clinical symptoms such ashemoptysis or anemia, may be helpful in the diagnosis of diffuse pulmonary hemorrhage.

Keyword

Lung, hemorrhage; Lung, CT; Lung, radiography

MeSH Terms

Anemia
Antiphospholipid Syndrome
Biopsy
Diagnosis
Follow-Up Studies
Hemorrhage*
Hemosiderosis
Humans
Lung
Macrophages
Purpura
Radiography, Thoracic
Retrospective Studies
Tomography, X-Ray Computed
Wegener Granulomatosis
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