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Imaging of the thorax in AIDS

Department of Radiology, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK

View larger version (168K): [in a new window]   Figure 1. Adult male HIV patient with Pneumocystis carinii pneumonia. The chest radiograph shows typical bilateral ground-glass shadowing, cystic change in the right upper lobe and a left pneumothorax.

View larger version (91K): [in a new window]   Figure 2. 33-year-old male with AIDS and Pneumocystis carinii pneumonia. High resolution CT demonstrates bilateral ground-glass opacity, lung consolidation, multiple thin-walled cysts and several thickened interlobular septae.

View larger version (107K): [in a new window]   Figure 3. 39-year-old male AIDS patient with a community-acquired pneumonia complicated by an empyema. Contrast enhanced CT demonstrates pulmonary consolidation (straight arrow) and a loculated left-sided pleural fluid collection (curved arrows).

View larger version (182K): [in a new window]   Figure 4. Adult male HIV-positive patient with a community-acquired staphylococcal pneumonia. The chest radiograph shows a right upper lobe pulmonary consolidation with central cavitation.

View larger version (97K): [in a new window]   Figure 5. 36-year-old male HIV-positive patient with recurrent bronchitis. Thin section CT demonstrates extensive segmental and subsegmental bronchiectasis(straight arrows) with diffuse air trapping and several centrilobular nodules due to plugging of small airways (curved arrow).

View larger version (104K): [in a new window]   Figure 6. 39-year-old AIDS patient with endobronchial spread of pulmonary tuberculosis diagnosed on sputum culture. Thin section CT demonstrates multiple thick-walled cavities (straight arrow) and a "tree in bud" appearance due to plugging of small airways (curved arrow).

View larger version (85K): [in a new window]   Figure 7. 18-year-old male with HIV and primaryMycobacterium tuberculosis infection. Contrast enhanced CT demonstrated multiple, enlarged and centrally necrotic mediastinal lymph nodes (arrow). Minor, right upper lobe pulmonary consolidation was also demonstrated on the lung windows (not shown).

View larger version (88K): [in a new window]   Figure 8. 33-year-old male with Mycobacterium avium complex infection diagnosed on blood cultures. Chest CT demonstrates multiple, well defined, soft tissue nodules throughout both lungs.

View larger version (110K): [in a new window]   Figure 9. 36-year-old male AIDS patient with pulmonary cryptococcal infection. Thin section CT demonstrates diffuse ground-glass shadowing, pulmonary nodules (curved arrow) and an area of mass-like consolidation in the left upper lobe (straight arrows). Cryptococcus neoformans was isolated from the sputum and the lesions resolved on anti-fungal therapy.

View larger version (141K): [in a new window]   Figure 10. 25-year-old female HIV patient with lymphocytic interstitial pneumonitis (LIP). The chest radiograph demonstrates typical changes of LIP with a bilateral nodular infiltrate predominantly distributed in the mid and lower zones. The diagnosis was established by exclusion of infective organisms and demonstration of typical features on transbronchial biopsy.

View larger version (110K): [in a new window]   Figure 11. Pulmonary Kaposi's sarcoma in a 39-year-old male AIDS patient. Thin section chest CTshows multiple, bilateral lung masses and ground-glass opacity plus bilateral pleural effusions.

View larger version (109K): [in a new window]   Figure 12. 58-year-old male with AIDS-related lymphoma. A solitary peripheral pulmonary mass is shown in the left lower lobe on the plain chest radiograph. The diagnosis of high grade, B-cell non Hodgkin's lymphoma was made on CT guided biopsy.

View larger version (99K): [in a new window]   Figure 13. 45-year-old male AIDS patient with bronchioloalveolar cell carcinoma. Contrast enhanced CT demonstrates extensive bilateral pulmonary opacity with air bronchograms (arrows). Several small discreet nodules are also demonstrated.

View larger version (133K): [in a new window]   Figure 14. 47-year-old HIV-positive male with non-specific pneumonitis. High resolution CT demonstrates patchy ground-glass opacity plus consolidation, bronchiectasis and air trapping causing reduced lung attenuation with associated vascular attenuation.