Peripheral Consolidation Research Articles

(Patho)physiological Significance of the Serum- and Glucocorticoid-Inducible Kinase Isoforms

The serum- and glucocorticoid-inducible kinase-1 (SGK1) is ubiquitously expressed and under genomic control by cell stress (including cell shrinkage) and hormones (including gluco- and mineralocorticoids). Similar to its isoforms SGK2 and SGK3, SGK1 is activated by insulin and growth factors via phosphatidylinositol 3-kinase and the 3-phosphoinositide-dependent kinase PDK1. SGKs activate ion channels (e.g., ENaC, TRPV5, ROMK, Kv1.3, KCNE1/KCNQ1, GluR1, GluR6), carriers (e.g., NHE3, GLUT1, SGLT1, EAAT1-5), and the Na+-K+-ATPase. They regulate the activity of enzymes (e.g., glycogen synthase kinase-3, ubiquitin ligase Nedd4-2, phosphomannose mutase-2) and transcription factors (e.g., forkhead transcription factor FKHRL1, beta-catenin, nuclear factor kappaB). SGKs participate in the regulation of transport, hormone release, neuroexcitability, cell proliferation, and apoptosis. SGK1 contributes to Na+ retention and K+ elimination of the kidney, mineralocorticoid stimulation of salt appetite, glucocorticoid stimulation of intestinal Na+/H+ exchanger and nutrient transport, insulin-dependent salt sensitivity of blood pressure and salt sensitivity of peripheral glucose uptake, memory consolidation, and cardiac repolarization. A common ( approximately 5% prevalence) SGK1 gene variant is associated with increased blood pressure and body weight. SGK1 may thus contribute to metabolic syndrome. SGK1 may further participate in tumor growth, neurodegeneration, fibrosing disease, and the sequelae of ischemia. SGK3 is required for adequate hair growth and maintenance of intestinal nutrient transport and influences locomotive behavior. In conclusion, the SGKs cover a wide variety of physiological functions and may play an active role in a multitude of pathophysiological conditions. There is little doubt that further targets will be identified that are modulated by the SGK isoforms and that further SGK-dependent in vivo physiological functions and pathophysiological conditions will be defined.

Organizing pneumonia: typical and atypical HRCT patterns

Organizing pneumonia (OP) is a clinical-pathological entity that, if idiopathic, makes part of the idiopathic interstitial pneumonias classification of the American Thoracic Society/European Respiratory Society (ATS/ERS) of 2002 (50% of the cases, called cryptogenic organizing pneumonia, or COP). In the remaining 50% it is secondary, representing one modality of response of the lung to various forms of injury. Typical computed tomography (CT) pattern has been widely described and consists of peripheral parenchymal consolidations with air bronchogram with or without surrounding ground-glass-like opacities. The purpose of this article is to describe the less frequent imaging pattern of this disease represented by single or multiple focal lesions (nodules or masses that place diagnostic problems with malignancy), bronchocentric pattern (parenchymal consolidations with peribronchovascular distribution), atoll sign (central area of ground-glass-like density and peripheral area of consolidation), nodular lesions (poorly defined micronodular pattern), linear and band-like opacities (subpleural linear opacities that can have disposition parallel or perpendicular in relation to the pleura), perilobular pattern (thickening of the interlobular septa with reticular pattern) and progressive fibrotic pattern (irregular thickening of the interlobular septa with associated ground-glass-like appearance and consolidations).

Idiopathic Interstitial Pneumonias: CT Features

Idiopathic interstitial pneumonias comprise usual interstitial pneumonia (UIP), nonspecific interstitial pneumonia (NSIP), desquamative interstitial pneumonia (DIP), respiratory bronchiolitis-associated interstitial lung disease (RB-ILD), cryptogenic organizing pneumonia (COP), acute interstitial pneumonia (AIP), and lymphoid interstitial pneumonia (LIP). Each of these entities has a typical imaging and histologic pattern, although in practice the imaging patterns may be variable. Each entity may be idiopathic or may be secondary to a recognizable cause such as collagen vascular disease or inhalational exposure. The diagnosis of idiopathic interstitial pneumonia is made by means of correlation of clinical, imaging, and pathologic features. The characteristic computed tomographic (CT) features of UIP are predominantly basal and peripheral reticular pattern with honeycombing and traction bronchiectasis. NSIP is characterized by predominantly basal ground-glass opacity and/or reticular pattern, often with traction bronchiectasis. DIP and RB-ILD are smoking-related lung diseases characterized by ground-glass opacity and centrilobular nodules. COP is characterized by patchy peripheral or peribronchovascular consolidation. AIP manifests as diffuse lung consolidation and ground-glass opacity. LIP is associated with a CT pattern of ground-glass opacity sometimes associated with perivascular cysts.

Ancillary lung parenchymal findings at spiral CT scanning in Pulmonary embolism. Relationship to chest sonography

Introduction/objective:The aim of the study was to compare findings of transthoracic sonography (TS) and of spiral computed tomography (sCT) in patients with suspected pulmonary embolism (PE). Methods and patients:Peripheral parenchymal and pleural findings of TS and sCT were compared in 62 patients (25 females, 37 males; mean age 62.2 years) with suspected PE. Results: In 39 patients PE was established, of whose pleura-based lesions could be detected by TS in 30 patients and by sCT in 31 patients. Whilst in three of the patients parenchymal lesions were exclusively detected by sonography, no peripheral abnormalities could be discovered with either technique in five patients. Among the nine patients lacking peripheral abnormalities on sonography, four revealed peripheral lesions in sCT. In 23 patients without PE, peripheral consolidations at CT were detected in six patients whereas two showed lesions on TS. With respect to the appearance, pleura-based wedge-shaped consolidations were the main parenchymal alterations (82.4% at TS, 66.1% at sCT) as compared with non-wedge-shaped consolidations (17.6% at TS, 33.9% at sCT). Peripheral lesions were located preferentially within the lower lobes. In addition, both localised and basal pleural effusion associated with PE could be demonstrated in 58.9% at TS and in 23.1% by sCT. Discussions and conclusion:The study shows that in PE parenchymal and pleural changes are detectable by TS and sCT. If parenchymal findings are present at sCT, peripheral PE should be considered, even in the absence of directly visible emboli. © 2003 Elsevier Ireland Ltd. All rights reserved.

Severe acute respiratory syndrome: radiographic review of 40 probable cases in Toronto, Canada.

To review radiographic findings of patients with probable severe acute respiratory syndrome (SARS) who were seen at a University of Toronto (Ontario, Canada) teaching hospital. Findings were reviewed for 40 patients who fulfilled the World Health Organization criteria for probable SARS. A template was designed for the analysis of each serial radiograph to observe patterns and distribution of disease, interval changes, and complications. The majority of radiographs were anteroposterior views. A clinical database of these patients was also collected for clinical-radiologic comparison. The mean age of the patients (18 male, 22 female) was 42.7 years. Patients had a normal chest radiograph and focal, multifocal, and/or bilateral consolidation. The pattern of consolidation tended to be peripheral and poorly marginated and involved middle and lower lung zones. The serial sequence fell into two major subgroups, which correlated closely with clinical outcome. Consolidation in one group cleared within a matter of days, while the second group went on to develop rapid and extensive bilateral pneumonia, with a prolonged hospital stay. Subsegmental atelectasis and pleural complications were rarely observed. SARS pneumonia can manifest as focal peripheral consolidation that clears relatively quickly and does not cause secondary complications or that progresses to bilateral consolidation and a more protracted clinical course.

Ancillary lung parenchymal findings at spiral CT scanning in pulmonary embolism. Relationship to chest sonography

Introduction/objective: The aim of the study was to compare findings of transthoracic sonography (TS) and of spiral computed tomography (sCT) in patients with suspected pulmonary embolism (PE). Methods and patients: Peripheral parenchymal and pleural findings of TS and sCT were compared in 62 patients (25 females, 37 males; mean age 62.2 years) with suspected PE. Results: In 39 patients PE was established, of whose pleura-based lesions could be detected by TS in 30 patients and by sCT in 31 patients. Whilst in three of the patients parenchymal lesions were exclusively detected by sonography, no peripheral abnormalities could be discovered with either technique in five patients. Among the nine patients lacking peripheral abnormalities on sonography, four revealed peripheral lesions in sCT. In 23 patients without PE, peripheral consolidations at CT were detected in six patients whereas two showed lesions on TS. With respect to the appearance, pleura-based wedge-shaped consolidations were the main parenchymal alterations (82.4% at TS, 66.1% at sCT) as compared with non-wedge-shaped consolidations (17.6% at TS, 33.9% at sCT). Peripheral lesions were located preferentially within the lower lobes. In addition, both localised and basal pleural effusion associated with PE could be demonstrated in 58.9% at TS and in 23.1% by sCT. Discussions and conclusion: The study shows that in PE parenchymal and pleural changes are detectable by TS and sCT. If parenchymal findings are present at sCT, peripheral PE should be considered, even in the absence of directly visible emboli.

A major outbreak of severe acute respiratory syndrome in Hong Kong.

There has been an outbreak of the severe acute respiratory syndrome (SARS) worldwide. We report the clinical, laboratory, and radiologic features of 138 cases of suspected SARS during a hospital outbreak in Hong Kong. From March 11 to 25, 2003, all patients with suspected SARS after exposure to an index patient or ward were admitted to the isolation wards of the Prince of Wales Hospital. Their demographic, clinical, laboratory, and radiologic characteristics were analyzed. Clinical end points included the need for intensive care and death. Univariate and multivariate analyses were performed. There were 66 male patients and 72 female patients in this cohort, 69 of whom were health care workers. The most common symptoms included fever (in 100 percent of the patients); chills, rigors, or both (73.2 percent); and myalgia (60.9 percent). Cough and headache were also reported in more than 50 percent of the patients. Other common findings were lymphopenia (in 69.6 percent), thrombocytopenia (44.8 percent), and elevated lactate dehydrogenase and creatine kinase levels (71.0 percent and 32.1 percent, respectively). Peripheral air-space consolidation was commonly observed on thoracic computed tomographic scanning. A total of 32 patients (23.2 percent) were admitted to the intensive care unit; 5 patients died, all of whom had coexisting conditions. In a multivariate analysis, the independent predictors of an adverse outcome were advanced age (odds ratio per decade of life, 1.80; 95 percent confidence interval, 1.16 to 2.81; P=0.009), a high peak lactate dehydrogenase level (odds ratio per 100 U per liter, 2.09; 95 percent confidence interval, 1.28 to 3.42; P=0.003), and an absolute neutrophil count that exceeded the upper limit of the normal range on presentation (odds ratio, 1.60; 95 percent confidence interval, 1.03 to 2.50; P=0.04). SARS is a serious respiratory illness that led to significant morbidity and mortality in our cohort.

Chest CT findings and clinical features in mild Legionella pneumonia.

To evaluate mild Legionella pneumonia (LP) by chest CT, and clinical features. In June 2000, an outbreak of LP occurred in Japan. Eight patients with mild LP (seven men, one woman; mean age 55.9 years) had fevers of more than 38 degrees C, but respiratory symptoms were observed only in four. Chest CT was performed before starting an appropriate treatment. CT images were assessed by the distribution of ground-glass opacity (GGO), consolidation, and the existence of pleural effusion. Chest CT findings: multiple segments were affected in all of the patients, (pleural effusion in three, peripheral lung consolidation in seven, and GGO in seven). GGO was located around the consolidation in six patients. Mild LP may present as fever without respiratory symptoms. Chest CT findings of mild LP are bilateral, multiple affected segments and peripheral lung consolidation with GGO.

SARS : A Tale of Two Epidemics.

SARS : A Tale of Two Epidemics.

CT findings of leukemic pulmonary infiltration with pathologic correlation.

The aim of this study was to demonstrate the characteristic CT findings of leukemic pulmonary infiltration based on the pathologic findings. The CT findings of 11 leukemic patients with leukemic pulmonary infiltration were compared with those of 22 leukemic patients with other diseases as a control group. Evaluated pulmonary parenchymal CT findings included thickening of bronchovascular bundles and interlobular septa, prominence of peripheral pulmonary arteries, ground-glass opacities, air-space consolidation, and nodules. The CT-pathologic correlations for leukemic infiltration were evaluated in 7 patients. Frequent parenchymal CT findings were thickening of bronchovascular bundles (81.8%), prominence of peripheral pulmonary arteries (81.8%), and non-lobular and non-segmental ground-glass opacities (90.9%). The first two findings were significantly more frequently observed in leukemic infiltration than in the control group, had good interobserver agreement, and corresponded pathologically to leukemic cell infiltration around the pulmonary arteries, bronchi, or bronchioles. Non-lobular and non-segmental ground-glass opacity corresponded to leukemic cell infiltration within alveolar spaces and septa adjacent to the pulmonary arteries or bronchi and also corresponded to hemorrhage, edema, or diffuse alveolar damage. Thickening of bronchovascular bundles and prominence of peripheral pulmonary arteries are CT findings suggestive for leukemic infiltration and correspond to peribronchovascular tumor extension.

HRCT Finding of Pulmonary Cryptococcosis in Immune Competent Patients

Purpose: To determine the HRCT finding of pulmonary cryptococcosis in immunocompetent patients. Materials and Methods: The HRCT scans and chest radiographs of five patients with pulmonary cryptococcosis were retrospectively reviewed, the diagnosis being proven by the presence of the organism in histopathologic specimens obtained during CT-guided biopsy (n = 4) or medistinoscopic biopsy (n = 1). All patients were immunocompetent. HRCT scans and chest radiographs were characterized according to morphology [consolidation, nodule, ground-glass opacity (GGO), interstitial thickening], location, airbronchogram, and the presence or absence of mediastinal or hilar lymphadenopathy. Results: Consolidation was present in three of five patients, and in two of the three, ill-defined, spiculated nodules were also present. One patient had multiple, small, well-defined nodules. One had diffuse interstitial thickening (GGO, nodular thickening of bronchovascular bundles and interlobular septa), with massive mediastinal and right hilar lymphadenopathy. The location of the consolidation and nodules was mainly peripheral, and in three patients with consolidation, the presence of air bronchograms was noted. Conclusion: The HRCT findings of pulmonary cryptococcosis in immunocompetent patients are peripheral consolidation with airbronchogram and/or ill defined nodules.

Pulmonary thromboembolism in cats: 29 cases (1987–1997)

Objective To determine clinical signs, clinicopathologic abnormalities, radiographic findings, histologic abnormalities, and predisposing factors or diseases in cats with pulmonary thromboembolism (PTE). Design Retrospective study. Animals 29 cats in which PTE was confirmed at necropsy. Procedure Information on signalment, body weight, history, results of physical examination, results of CBC and serum biochemical analyses, whether PTE was suspected prior to death, type of indwelling venous catheter and duration of venous catheterization, results of thoracic radiography, and whether cats had any concurrent diseases was obtained from medical records. Results PTE was identified in cats of various ages (median, 8.7 years), weights (median, 4.1 kg [9 lb]), and breeds. The most common owner-reported problems included lethargy (17 cats), anorexia (14), weight loss (10), and difficulty breathing (8); physical abnormalities included lethargy (21), tachypnea or dyspnea (16), and dehydration (13). Clinicopathologic abnormalities reflected concurrent or underlying diseases. Common radiographic abnormalities included pulmonary vessel abnormalities (11), pleural effusion (8), and peripheral noncircumscribed consolidations (6). Underlying or predisposing conditions, including cardiac disease (12), neoplasia (10), corticosteroid administration (8), disseminated intravascular coagulation (5), protein-losing nephropathy (4) or enteropathy (4), immune-mediated hemolytic anemia (2), and sepsis (2) were identified in all cats. Conclusions and Clinical Relevance Results suggest that PTE can develop in cats of any age, sex, or breed. Because PTE is a serious, potentially life-threatening disease, it should be suspected in cats with thoracic radiographic changes suggestive of uneven distribution of blood flow between lung lobes, especially in cats that have predisposing factors or diseases. (J Am Vet Med Assoc 1999;215:1650–1654)

Role of interleukin-8 in community-acquired pneumonia: relation to microbial load and pulmonary function.

SummaryIn pneumonia local phagocyte activation is crucial for clearing of pathogenic microorganisms. In this context alveolar macrophage interleukin-8 secretion, phagocyte oxidative response and concentrations of lavage proteins were quantified, including interleukin-8, in 31 patients with pneumonia, 13 age matched patients with peripheral lung consolidation and six healthy volunteers; these findings were related to the impairment of gas exchange and the bacterial load in the alveolar space. Increased interleukin-8 levels were found in bronchoalveolar lavage fluid (BALF) and in alveolar macrophage supernatants from patients with pneumonia (214 ng/105 AM±121 vs 71 ng/105 AM±35 and 66 ng/105 AM±30, p<0.05). Interleukin-8 release from alveolar macrophages correlated with the upregulated spontaneous luminol enhanced oxidative response of pulmonary phagocytes but not with the neutrophil count in BALF. In pneumonia patients a significant difference was found between patients with 104 or more colony forming units (CFU)/ml BALF of one pathogen and patients with less CFU or nonspecific microbiological results (261 ng/105 AM±89 vs 179 ng/105 AM±81 and 7.5 ng/ml BALF±17 vs 0.44 ng/ml BALF±1, p<0.05). Further, a negative correlation between interleukin-8 release of alveolar macrophages and the arterial pO2 at the time of BALF could be demonstrated (r=−0.47, p<0.05). The results demonstrate local cellular activation in community-acquired pneumonia, which is related to the bacterial load in the alveolar space and to impairment of gas exchange. This is consistent with the hypothesis that pulmonary phagocytes play a central role in the pathogenesis of bacterial pneumonia, contributing not only to bacterial clearing but also to local tissue damage.

Bronchioloalveolar carcinoma: computed tomography findings

The aim of the present study was to investigate the appearance of bronchioloalveolar lung carcinoma on computed tomography (CT) scans, and to determine the frequency of signs suggestive of this diagnosis. CT features of 42 cases with pathologically proven bronchioloalveolar carcinoma were retrospectively analysed for pattern, size, location and secondary signs suggesting the diagnosis. Bronchioloalveolar carcinoma had one of the following patterns: solitary nodule or mass (16), lobar consolidation (10), multilobar consolidations (13) and diffuse nodules (3). The 16 solitary nodules or masses ranged in size from 2.0 to 9.4 cm (mean +/- SD 3.75 +/- 1.7 cm). Eleven of the 16 nodules or masses were peripheral and five were central: Eight of the 16 tumours had pleural tags, seven had spiculated margins, and three had bubblelike lucencies. The consolidations were peripherally distributed in 13 out of 23 cases; cystic airspaces were observed in 19 out of 23 consolidations; bulging of interlobar fissures in 8 out of 23; and the angiogram sign in 7 out of 23. In conclusion, computed tomography findings of bronchioloalveolar carcinoma have a wide spectrum, showing typically a peripheral nodule or consolidation. Computed tomography has a role in the diagnosis of nodular localized versus other forms, with subsequent therapeutic and prognostic implications.

Effect of respiratory tract viral infection on murine airway beta-adrenoceptor function, distribution and density.

1. The effects of a respiratory tract viral infection on beta-adrenoceptor density, distribution and function were investigated in murine airways. 2. Following intranasal inoculation of CBA/CaH mice with influenza A/PR-8/34 virus, the virus proliferated rapidly in trachea (peak titres 2 days post-inoculation) and lung (peak titres 4-6 days post-inoculation). Respiratory tract viral infection was associated with a significant increase in lung weight (88% higher than control mice at day 6 post-inoculation) that was related temporally to the development of peripheral lung inflammation and consolidation. 3. Analysis of specific binding of [125I]-cyanopindolol to beta-adrenoceptors revealed that on days 2, 4 and 8 post-inoculation with virus, mouse isolated tracheal sections contained, on average, 40% more beta-adrenoceptors than tracheal sections from time matched control mice. Subsequent quantitative autoradiographic studies demonstrated that this increase in total tracheal beta-adrenoceptors was due primarily to a 90% increase in the density of beta-adrenoceptors in the tracheal epithelium in virus-infected mice. 4. In contrast, virus-infection had no significant effect on the density of beta-adrenoceptors in tracheal airway smooth muscle, although within 2 days of inoculation with virus, mouse tracheal smooth muscle segments were approximately 2 fold less sensitive to the beta-adrenoceptor agonist, noradrenaline (mean pD2 = 6.57 +/- 0.04, n = 24) and to the adenylyl cyclase-activator forskolin (mean pD2 = 6.78 +/- 0.04, n = 12) compared to segments from control mice (mean pD2 = 6.84 +/- 0.06 for noradrenaline; mean pD2 = 7.03 +/- 0.07 for forskolin). Similar values were obtained 8 days post-inoculation. At day 2, but not day 8 post-inoculation with virus, relaxation responses to theophylline were also marginally attenuated compared with controls.5. Mouse isolated tracheal segments obtained 2 days after virus inoculation and segments from timematched control mice were equisensitive to the spasmogenic actions of the muscarinic cholinoceptor agonist, carbachol. However, tracheal segments from mice inoculated with virus were less responsive to carbachol on day 4 (mean pD2 = 6.45 + 0.04, n = 8) and day 8 (mean pD2 = 6.45 +/- 0.02, n = 12) compared to control preparations (day 4, mean pD2 = 6.73 +/- 0.06, n = 8; day 8, mean pD2= 6.65 +/- 0.04, n = 12, P < 0.05). In contrast, endothelin-l-induced contractions of tracheal smooth muscle were notaffected by virus-infection.6. These data demonstrate that respiratory tract viral infection can produce significant tissue-selective changes in airway /beta-adrenoceptor density as well as small reductions in airway smooth muscle muscarinic cholinoceptor and /beta-adrenoceptor function.

Obliterative Bronchiolitis Following Lung Transplantation Diagnostic Utility of Aerosol Ventilation Lung Scanning and High Resolution CT

A serious and often fatal complication of heart-lung transplantation is the development of obliterative bronchiolitis (OB). Currently the screening for OB is based on symptoms, pulmonary function tests, and transbronchial biopsies. The chest radiographs are often normal with OB. Obliterative bronchiolitis produces luminal narrowing of both bronchioles and bronchi resulting in areas of peripheral consolidation and occasional bronchiectasis. We report a patient in whom a chest film was normal, an aerosol ventilation lung scan was abnormal while a perfusion study was mildly abnormal. Simultaneously, routine CT was essentially normal while high resolution CT with 1 mm thick sections was clearly abnormal and demonstrated areas of consolidation. These imaging modalities detected clear-cut abnormalities at a time when the patient was symptomatic but prior to the development of demonstrable abnormality on chest radiograph.

High resolution computed tomography of Pneumocystis Carinii pneumonia in AIDS

High resolution computed tomography (CT) was performed on 11 homosexual men with the Acquired Immune Deficiency Syndrome (AIDS). All had bronchoscopically proven Pneumocystis carinii pneumonia (PCP). Six patients were re-scanned following treatment and symptomatic recovery. All the scans were abnormal, most showing fine diffuse bilateral alveolar consolidation with bronchial wall thickening, despite having a normal or near-normal chest radiograph in three cases. A variety of unexpected changes such as peripheral consolidation only, upper or lower zone predominance, unilaterality, bronchial dilatation, cystic air spaces and sub-pleural sparing were also seen. Following therapy, resolution of CT changes was shown to be incomplete despite clinical recovery, and whilst all the cases showed a reduction in alveolar consolidation, other findings such as new interstitial shadowing, peripheral predominance, and persistent cystic changes were observed, suggesting the healing process to be complex. Whilst the changes of PCP and its progression following treatment are well described on the plain chest radiograph, this is the first specific documentation of its appearances on narrow section CT, and its response to therapy. The usefulness of high resolution CT scanning to show early infection with PCP in the face of a normal chest radiograph is discussed, and the wide variety of CT changes occurring once the disease is established is emphasized.

Chronic eosinophilic pneumonia: CT findings in six cases.

We reviewed the chest radiographs and CT scans in six patients with proved chronic eosinophilic pneumonia. In all patients, the chest radiographs showed patchy air-space consolidation, and in five of six cases, the consolidation was most marked in the middle and upper lung zones. In only one patient was the classic pattern of air-space consolidation that is confined to the outer third of the lungs readily apparent. In three patients, the consolidation appeared to be diffuse, although a slight peripheral predominance was present. In two patients, a peripheral predominance was difficult to appreciate, even in retrospect. The CT scans in all cases showed peripheral air-space consolidation. In addition, mediastinal adenopathy was identified on CT scans in three cases. This has not been described before in association with chronic eosinophilic pneumonia. A follow-up CT scan in one patient showed resolution of the adenopathy and marked improvement in the peripheral air-space disease within 2 weeks. We conclude that patients with chronic eosinophilic pneumonia show predominantly peripheral air-space consolidation on CT scans, even when this distribution is not readily apparent on the radiograph. CT may be helpful in the diagnosis when the clinical findings are suggestive, but the radiographic pattern is nonspecific.

Roentgenographic findings in pulmonary mucormycosis.

ROENTGENOGRAPHIC FINDINGS IN PULMONARY MUCORMYCOSISROYAL J. BARTRUM, JR., M.D., MURRAY WATNICK, M.D. and PETER G. HERMAN, M.D.Audio Available | Share