student syb chet cunha ms iv january 29, 2009. history 35 y/o m complaining of dyspnea on exertion....

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Student SYB Chet Cunha MS IV January 29, 2009

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Page 1: Student SYB Chet Cunha MS IV January 29, 2009. History 35 y/o M complaining of dyspnea on exertion. Has had DOE x 5 years, but has recently worsened

Student SYB

Chet Cunha MS IVJanuary 29, 2009

Page 2: Student SYB Chet Cunha MS IV January 29, 2009. History 35 y/o M complaining of dyspnea on exertion. Has had DOE x 5 years, but has recently worsened

History

•35 y/o M complaining of dyspnea on exertion.

•Has had DOE x 5 years, but has recently worsened.

•Smokes 2ppd x 19yrs

Page 3: Student SYB Chet Cunha MS IV January 29, 2009. History 35 y/o M complaining of dyspnea on exertion. Has had DOE x 5 years, but has recently worsened

CT Chest

Page 4: Student SYB Chet Cunha MS IV January 29, 2009. History 35 y/o M complaining of dyspnea on exertion. Has had DOE x 5 years, but has recently worsened

CT Chest

Page 5: Student SYB Chet Cunha MS IV January 29, 2009. History 35 y/o M complaining of dyspnea on exertion. Has had DOE x 5 years, but has recently worsened

CT Chest

Page 6: Student SYB Chet Cunha MS IV January 29, 2009. History 35 y/o M complaining of dyspnea on exertion. Has had DOE x 5 years, but has recently worsened

CT Chest

Page 7: Student SYB Chet Cunha MS IV January 29, 2009. History 35 y/o M complaining of dyspnea on exertion. Has had DOE x 5 years, but has recently worsened

Alpha 1-antitrypsin deficiency

CXR Radiographic findings

•Loss of lung markings

Page 8: Student SYB Chet Cunha MS IV January 29, 2009. History 35 y/o M complaining of dyspnea on exertion. Has had DOE x 5 years, but has recently worsened

Alpha 1-antitrypsin deficiency

CT Radiographic findings

•Panacinar emphysema predominantly involving the lower lung fields

•Simplification of lung architecture (normal lung structures are replaced by abnormal airspaces)

•Diffuse cystic bronchiectasis

•Ground glass opacities

Page 9: Student SYB Chet Cunha MS IV January 29, 2009. History 35 y/o M complaining of dyspnea on exertion. Has had DOE x 5 years, but has recently worsened

Alpha 1-antitrypsin

deficiency Treatment Options

•Supplemental O2

•Inhaled Beta agonists and corticosteroids

•Alpha 1-antitrypsin replacement therapy

•Lung volume reduction surgery

•Lung transplantation

Page 10: Student SYB Chet Cunha MS IV January 29, 2009. History 35 y/o M complaining of dyspnea on exertion. Has had DOE x 5 years, but has recently worsened

Further Reading

• Gourtsoyiannis, N.C., Ros, P.R. Radiologic-Pathologic Correlations from Head to Toe. Springer Publishing, Berlin 2005.

• Grossman, Z.D., Katz, D. S., et al. Cost-Effective Diagnostic Imaging. Mosby Elsevier, Philadelphia, 2006.

• CXR image courtesy of eMedicine

Page 11: Student SYB Chet Cunha MS IV January 29, 2009. History 35 y/o M complaining of dyspnea on exertion. Has had DOE x 5 years, but has recently worsened

Thank you!