Paratracheal Air Cysts of Thoracic Inlet in Adults: CT Findings

PURPOSE: To evaluate the frequency of a paratracheal cyst on CT in an adult, and to compare the degree of loculation and the patient's age with the longest diameter of the air cysts. MATERIALS AND METHODS: Of 1520 patients, who underwent a CT scan, 41 patients with paratracheal cysts were enrolled in this study. There were 26-males and 15 females, whose ranged from 24 to 82 years (mean, 59.8). The CT findings were evaluated to determine the relationship between the degree of loculation and the longest diameter of the air cysts. Another tracheal diverticula or an air cyst, as well as the tracheal communication were also evaluated. RESULTS: The longest diameter of the paratracheal air cysts was 1 cm (p=0.043). The paratracheal air cysts 2 cm were multilocular. Four patients had another small tracheal diverticula, and one patient had another small paratracheal air cyst. Tracheal communication was observed in 7 patients (17%). CONCLUSION: The frequency of paratracheal air cysts in adults undergoing a CT scan was 2.7%. The longest diameter of the paratracheal air cysts was associated with the patient's age. The shape of air cysts became more multilocular as the longest diameter of the paratracheal air cysts increased. Another small tracheal diverticula or air cysts were observed in 12% of patients.

Tracheopathia Osteoplastica Associated with Anthracofibrosis: Case Report

Tracheopathia osteoplastica is a rare benign disorder of the trachea and major bronchi. It is characterized by multiple cartilaginous or osseous submucosal nodules that project into the tracheobronchial lumen. Awareness of the condition is important to avoid unnecessary surgery. We report here on the CT and bronchoscopic findings of tracheopathia osteoplastica associated with anthracofibrosis in a 67-year old woman, and we will then discuss our findings.

Paratracheal Air Cysts: Sonographic Findings in Two Cases

We report two cases of paratracheal air cyst discovered incidentally at neck ultrasonography and confirmed at CT. The cysts were located at the inferoposterior aspect of the right lobe of the thyroid. Ultrasonography revealed an ill-defined hypoechoic mass containing hyperechoic foci which mimicked calcifications. Neck CT confirmed the presence of an ill-defined air pocket which communicated with the trachea through a slit.

Imaging Features of Nontumorous Conditions Involving the Trachea and Main-stem Bronchi

A number of nontumorous diseases may affect the trachea and main-stem bronchi, and their nonspecific symptoms may include coughing, dyspnea, wheezing and stridor. The clinical course is often long-term and a misdiagnosis of bronchial asthma is common. The imaging findings of these nontumorous conditions are, however, relatively characteristic, and diagnosis either without or in conjunction with clinical information is often possible. For specific diagnosis, recognition of their imaging features is therefore of prime importance. In this pictorial essay, we illustrate the imaging features of various nontumorous conditions involving the trachea and main-stem bronchi.

Tracheal Involvement of Bronchus-Associated Lymphoid Tissue Lymphoma: A Case Report

Primary malignant tumors of the trachea are rare, the most prevalent histologies beeing squamous cell and adenoid cystic carcinoma. A review of the literature revealed only ten cases of primary tracheal or bronchial non-Hodgkin's lymphoma. We describe a case in which tracheal involvement of bronchus-associated lymphoid tissue lymphoma, a subtype of non-Hodgkin's lymphoma, occurred.

Helical CT of a Tracheobronchial Phantom: Angle and Optimal Window Affecting Size Measurements of ThreeDimensional Images

PURPOSE: To determine the effect of angle variation, relative to scan plan and optimal window setting, on thesize of three dimensional spiral CT images of a tracheobronchial tree using a phantom. MATERIALS AND METHODS:Spiral CT[collimation(mm)/table speed(mm/sec): 3/3; reconstruction interval:1.5 mm] was performed on atracheobronchial phantom consisting of a box filled with saline solution containing air-filled 5cc syringesoriented at varying angles relative to the scan plan. The diameter of three dimensional images was measured ateach window(minimal threshold value; -1000 HU; maximaml threshold value: from -300 HU to -500 HU; 50 HU interval). RESULTS: The inner diamenter of syringes used for tracheobronchial phantom was 12.55 +/-3.19mm. At all windows,as the angle became more perpendicular, the diameter of three-dimensional images increased, and at all angles, asmaxinal HU increased, measured diameter also increased(p<0.0001). In particular, at a maximal value of -500HU,measured values were closest to control values at all angles. CONCLUSION: Diameter can be measured close tocontrol value from three dimensional spiral CT images at maximal HU of -500 window, regardless of angle.

CT Diagnosis of Tracheobronchial Rupture Following Blunt Trauma with Demonstration of the Injury Site: A Case Report1

Tracheobronchial disruption is a rare injury associated with blunt trauma, and for proper management, accurate diagnosis is essential. We describe a case of isolated tracheal rupture following blunt trauma, and the related CT findings, including details of the injury site. Preoperative bronchoscopy was not performed, but the patient immediately underwent surgery, which was successful. This case demonstrates that CT scanning is very helpful both for diagnosis of tracheobronchial injury and for delineation of the exact injury site.

CT Findings of Tracheal Mucormycosis: A Case Report

Pulmonary mucormycosis is a opportunistic mycosis, typically occurring in immunocompromised or diabetic patients. It is characterized as an infection of the pulmonary parenchyma and larger bronchi, and involves extensive vascular thrombosis and tissue necrosis. A variety of CT findings have been reported, but tracheal involvement is extremely rare. We report the case of a patient with tracheal mucormycosis placing particular emphasis on the CT findings.

Leiomyoma of the Trachea: A Case Report

Tracheal leiomyoma is a rare benign tumor arising from the smooth muscle in the tracheal wall. As in other cases of benign tracheal tumors, the obstructive symptoms due to leiomyoma are similar to those of asthma and bronchitis, and diagnostic delay is therefore common. We describe the case of a patient with leiomyoma arising from the trachea and review the literature, with particular emphasis on the two dimensional CT images.

CT Findings of Tracheal Lipoma: A Case Report

A patient with a history of asthma underwent computed tomography (CT). With a soft tissue window (width 330, level 30) the scan of the neck did not show any lesion within the airway lumen, but with a lung parenchymal window(width 1300, level -500), we were able to find a low attenuationg endotracheal mass lesion measuring -320HU. A bronchoscopy was performed and a polypoid mass approximately 2cm in diameter was found within the tracheal lumen. An endoscpic biopsy was not performed due to the risk of bleeding and the bronchoscopy was inconclusive for tissue diagnosis. CT, however, provided a definitive diagnosis by demonstrating fat within the tumor on the lung window.

CT Findings of Tracheal Lipoma: A Case Report

A patient with a history of asthma underwent computed tomography (CT). With a soft tissue window (width 330, level 30) the scan of the neck did not show any lesion within the airway lumen, but with a lung parenchymal window(width 1300, level -500), we were able to find a low attenuationg endotracheal mass lesion measuring -320HU. A bronchoscopy was performed and a polypoid mass approximately 2cm in diameter was found within the tracheal lumen. An endoscpic biopsy was not performed due to the risk of bleeding and the bronchoscopy was inconclusive for tissue diagnosis. CT, however, provided a definitive diagnosis by demonstrating fat within the tumor on the lung window.

Benign Neoplasms of the Trachea: Case Reports

Benign tumors of the trachea are rare, accounting for approximately 10% of all primary tracheal neoplasms. They are frequently misdiagnosed and managed as bronchial asthma or chronic bronchitis. We report a lipoma and a leiomyoma of the trachea with emphasis on the clinical, radiographic and CT findings, and review the literature.

Benign Neoplasms of the Trachea: Case Reports

Benign tumors of the trachea are rare, accounting for approximately 10% of all primary tracheal neoplasms. They are frequently misdiagnosed and managed as bronchial asthma or chronic bronchitis. We report a lipoma and a leiomyoma of the trachea with emphasis on the clinical, radiographic and CT findings, and review the literature.

The Usefulness of Three-Dimensional Imaging with Spiral CT in the Evaluation of Upper Airway Stenosis

PURPOSE: To assess the usefulness of three-dimensional (3D) spiral CT imaging in patients with upper airway stenosis. MATERIALS AND METHODS: We performed 3D spiral CT imagings in ten patients in whom upper airway stenosis was clinically suspected. Eight of these patients had upper airway stenosis caused by intubation or tracheostomy(n=6), tuberculosis (n=1), or extrinsic compression by a thyroid mass (n=1). Spiral CT scanning(30-second continuous exposure and 90-mm length) was performed with a table speed of 3mm/sec and a section thickness of 3mm.The selected starting point was the epiglottis. The resulting data were reformatted by multiplanar reformation(MPR) and shaded surface display (SSD) with peeling after reconstruction of 2mm interval. In the evaluation oflocation and extent of stenosis, we compared fidings of 3D imaging with those of baseline axial images (n=10), endoscopy (n=9) and operation (n=4). RESULTS: The locations of stenosis in eight patients were as follows: tracheostoma (n=4), subglottic region (n=3), and larynx (n=1). In all eight patients, 3D imaging demonstrated the location and extent of stenosis, which exactly correlated with endoscopic and operative findings. In one patient, however, another stenotic area in the tracheal bifurcation was not discovered because this lesion was not includedin the field of CT scan. In two patients, the diagnosis on 3D images of 'no stenosis' was comfirmed by clinical findings or operation. No differences in diagnostic accuracy were noted between axial images, MPR, and SSD when evalvating the location and extent of stenosis ; vertical extent was shown more easily by 3D imaging than by axialimages, however. CONCLUSION: 3D imaging with spiral CT may be an useful adjunctive method in the evaluation of upper airway stenosis with variable causes.