Radloraphics lnd#{149}x terms: COMPUTED TOMOGRAPHY #{149} Pulmonary PULMONARY IMAGING #{149} Bronchi and Lungs #{149} Pleura & Pleural Space Cumulative index terms: Acquired immunodeficiency syndrome (AIDS) Lung; Infection Lymphoma Abstract: The advantages ofcomputed tomography for the evaluation of various chest lesions commonly encountered In patients with AIDS are diacuued. The significance ofllmlted and extensive iymphadenopathy is considered and examples are presented. Also speciflcaiIy fflusfrated are cases ofopportunistic pneumocystis, cytomegalovlrus, and nocardla pneumonitides and ofcandida esophagitis; septic emboii; empyema; premature bulla formation ranging from apical bullae to diffuse parenchymai destruction; Kaposi’s sarcoma, and iymphoma. Examples of the value ofCT in resolving obscure clinical chest problems in AIDS lents are also Illustrated. THIS EXHIBIT WAS DISPLAYED AT THE 74TH SCIENTIFIC ASSEMBLY AND ANNUAL MEETING OF THE RA- DIOLOGICAL SOCIETY OF NORTH AMERICA, NOVEMBER 27-DECEM- BER 2, 1988, CHICAGO, ILLINOIS. IT WAS RECOMMENDED BY THE COMPUTED TOMOGRAPHY AND CHESTIMAGING PANELS AND WAS ACCEPTED FOR PUBLICATIONAF- TER PEER REVIEW AND REVISION ON FEBRUARY10, 1989. From the Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institu- tions, Baltimore, Maryland. Address reprint requests to J. E. Kuhlman, M.D., Depart- ment of Radiology, The Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21205. Volume 9, Number 5 #{149} September, 1989 #{149} RadloGraphlcs 827 Diseases of the chest in AIDS: CT diagnosis Janet E. Kuhiman, M.D. Meg Knowles, B.S. Elliot K. Fishman, M.D. Elias A. Zerhouni, M.D. Ralph H. Hruban, M.D. Stanley S. Siegelman, M.D. Introduction Since 1981, the acquired immunodeficiency syndrome (AIDS) has become a worldwide epidemic. AIDS is caused by the human immunodeficiency virus (HIV). Groups at high risk for the infection include homosexual males (74%), intravenous drug abusers (16%), and patients transfused with blood products contaminated with the HIV virus (3%) (1,2). Some of the newly reported cases of AIDS include female sexual partners of drug users and bisexual men, and infants born to women with the AIDS virus (2). More than 60% of patients with AIDS demonstrate pulmonary disease at some point in the course of their illnesses (2). Although there is considerable overlap in the radiographic appearance of many of the pulmonary disorders encountered in AIDS, certain patterns of involvement have begun to emerge. Computed tomography can play an important role in the initial workup and management of patients with known or suspected AIDS. CT identifies the presence or absence of significant pulmonary parenchymal involvement with greater sensitivity than plain radiographs (3,4). Further, CT can characterize the type, extent, and distribution of pulmonary disease, and on the basis of these characteristics, may suggest that certain diagnoses are more likely than others. CT helps to clarify confusing radiographic findings in the chest when extensive disease is present; it also helps the physician to plan further diagnostic workup and may serve to direct invasive biopsy procedures. For these reasons, it is important to be familiar with the CT manifestations of AIDS related disorders of the chest.