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British Journal of Radiology (2006) 79, e174-e176
© 2006 British Institute of Radiology
doi: 10.1259/bjr/17487872
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Multiple cavitating masses in an immunocompromised host with rheumatoid arthritis-related interstitial lung disease: an unusual expression of cytomegalovirus pneumonitis

A P Ayyappan, MD 1 R Thomas, MD 2 S Kurian, MD 3 D J Christopher, MD 2 and R Cherian, DMRD, FRCR 1

Departments of 1Radiodiagnosis 2Respiratory Medicine and 3Pathology, Christian Medical College and Hospital, Vellore, Tamil Nadu, 632 004 India


Figure 1
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  		Figure 1. Thin-section (1 mm collimation) CT scan through the basal segments demonstrates areas of ground-glass attenuation, intralobular reticular opacities and honey combing (black arrows).

 

Figure 2
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  		Figure 2. Frontal chest radiograph obtained at presentation shows consolidation with cavitation(black arrow) in the right upper lobe. There is an area of consolidation (white arrow) in the left middle lung zone.

 

Figure 3
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  		Figure 3. Thin-section (1 mm collimation) CT scan of the right lung obtained 2 cm above the tracheal carina demonstrates dense cavitating mass in the upper lobe (black arrow) contiguous with the pleura. Tracheal lumen shows mucus (white arrow).

 

Figure 4
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  		Figure 4. Thin-section (1 mm collimation) CT scan of the left lung shows a small cavitating mass in the lingula (black arrow) abutting the pleura.

 

Figure 5
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  		Figure 5. Photomicrograph of the gastric biopsy specimen. Haematoxylin-eosin, original magnification x400. Gastric mucosa shows intracytoplasmic viral inclusions (black arrow).

 

Figure 6
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  		Figure 6. Photomicrograph of the trans-bronchial lung biopsy specimen. Haematoxylin-eosin, original magnification x400. Lung alveolar epithelium shows viral inclusions (black arrow).

 

Figure 7
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  		Figure 7. Radiograph obtained 6 weeks after treatment shows resolution of areas of consolidation.

 




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