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THIRD EDITION
Rosado-de-Christenson
Martínez-Jiménez
Restrepo | Betancourt-Cuellar
Carter | Lichtenberger
Heeger | Ternes
Carrillo-Bayona | Frazier
Silva | Garrana
Alegría | Fuss
ii
THIRD EDITION
Santiago Martínez-Jiménez, MD
Department of Radiology
Saint Luke's Hospital of Kansas City
Professor of Radiology
University of Missouri-Kansas City School of Medicine
Kansas City, Missouri
iii
Elsevier
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This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as
may be noted herein).
Notices
Practitioners and researchers must always rely on their own experience and knowledge in
evaluating and using any information, methods, compounds or experiments described herein.
Because of rapid advances in the medical sciences, in particular, independent verification of
diagnoses and drug dosages should be made. To the fullest extent of the law, no responsibility is
assumed by Elsevier, authors, editors or contributors for any injury and/or damage to persons or
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any methods, products, instructions, or ideas contained in the material herein.
iv
Dedications
To my wonderful family – Paul, Jennifer, Heather, David, Mike, and Juniper,
for your unconditional love and support. You are everything to me.
MLR
To Isabela and Lucas. You are simply the best. Just keep smiling and
remember that monsters were never under the bed.
SMJ
v
Contributing Authors
Carlos S. Restrepo, MD Jorge Alberto Carrillo-Bayona, MD
Professor of Radiology Professor of Radiology
Director of Cardiothoracic Imaging Universidad Nacional de Colombia
Department of Radiology Hospital Universitario Mayor Mederi
The University of Texas RIMAB
Health Science Center at San Antonio Bogotá, Colombia
San Antonio, Texas
Aletta Ann Frazier, MD
Sonia L. Betancourt-Cuellar, MD Section Chief, Cardiothoracic Imaging
Professor of Thoracic Imaging ACR Institute for Radiologic Pathology (AIRP)
Department of Thoracic Imaging Silver Spring, Maryland
The University of Texas MD Anderson Cancer Center Professor of Diagnostic Radiology
Houston, Texas University of Maryland School of Medicine
Baltimore, Maryland
Brett W. Carter, MD, CPPS
Director of Clinical Operations Claudio Silva, MD, MSc, MBA
Chief Patient Safety and Associate Professor of Radiology
Quality Officer, Diagnostic Imaging Clínica Alemana - Universidad del Desarrollo
Professor of Thoracic Imaging School of Medicine
The University of Texas MD Anderson Cancer Center Cardiothoracic Imaging Division, Radiology Department
Houston, Texas Clínica Alemana de Santiago
Santiago, Chile
John P. Lichtenberger, III, MD
Chief of Thoracic Imaging Sherief H. Garrana, MD
Associate Professor of Radiology Assistant Professor of Radiology
Department of Radiology Department of Radiology
George Washington University Medical Saint Luke’s Hospital of Kansas City
Faculty Associates University of Missouri-Kansas City School of Medicine
Washington, D.C. Kansas City, Missouri
vi
Additional Contributing Authors
Gerald F. Abbott, MD, FACR
Jonathan Hero Chung, MD
Florian J. Fintelmann, MD, FRCPC
Tomás Franquet, MD, PhD
Terrance Healey, MD
Laura E. Heyneman, MD
Jeffrey P. Kanne, MD
Kyung Soo Lee, MD
Diane C. Strollo, MD, FACR
Christopher M. Walker, MD
Helen T. Winer-Muram, MD
Carol C. Wu, MD
vii
Preface
We proudly present the 3rd edition of Diagnostic Imaging: Chest. It is hard to believe
that 9 years have elapsed since the publication of the 2nd edition. I am immensely
grateful to the Elsevier team for giving me the opportunity to, once again, serve as
lead author of this work, and to my good friend, colleague, and practice partner, Dr.
Santiago Martínez-Jiménez, for serving as co-lead author.
The 3rd edition is similar to the 2nd in both style and appearance, with a succinct,
bulleted text format and image-rich depictions of a large number of cardiothoracic
diseases. The content is organized based on both anatomic location and category of
disease. The work is enhanced by a wealth of new material that includes:
• 13 updated and illustrated section introductions that set the stage for
the specific diagnoses that follow
• Updated sections that define and illustrate thoracic imaging terminology,
including many entities from the Fleischner Society glossary of terms, as well
as classic signs in chest imaging
• An updated section on posttreatment changes in the thorax and the
effects of novel therapies that include surgery, radiotherapy, chemotherapy,
immunotherapy, and ablation procedures
• New chapters on emerging diseases, including coronavirus disease-2019
(COVID-19) and e-cigarette or vaping product use-associated lung injury
(EVALI)
• A total of 344 chapters supplemented with updated material and references
• In all, 2,640 images and 2,536 online-only images that include radiographic,
CT,
MR, and PET/CT images, as well as gross photographs and
photomicrographs where appropriate
• Updated graphics that illustrate the anatomic/pathologic basis of various
imaging abnormalities
viii
Melissa L. Rosado-de-Christenson, MD, FACR
Section Chief, Thoracic Radiology
Department of Radiology
Saint Luke's Hospital of Kansas City
Professor of Radiology
University of Missouri-Kansas City School of Medicine
Kansas City, Missouri
ix
x
Acknowledgments
LEAD EDITOR
Terry W. Ferrell, MS
LEAD ILLUSTRATOR
Lane R. Bennion, MS
TEXT EDITORS
Arthur G. Gelsinger, MA
Rebecca L. Bluth, BA
Nina Themann, BA
Megg Morin, BA
Kathryn Watkins, BA
ILLUSTRATIONS
Richard Coombs, MS
Laura C. Wissler, MA
IMAGE EDITORS
Jeffrey J. Marmorstone, BS
Lisa A. M. Steadman, BS
PRODUCTION EDITORS
Emily C. Fassett, BA
John Pecorelli, BS
xi
xii
Sections
SECTION 1:
Overview of Chest Imaging
SECTION 2:
Developmental Abnormalities
SECTION 3:
Airway Diseases
SECTION 4:
Infections
SECTION 5:
Pulmonary Neoplasms
SECTION 6:
Interstitial, Diffuse, and Inhalational Lung Disease
SECTION 7:
Connective Tissue Disorders, Immunological Diseases, and Vasculitis
SECTION 8:
Mediastinal Abnormalities
SECTION 9:
Cardiovascular Disorders
SECTION 10:
Trauma
SECTION 11:
Post-Treatment Chest
SECTION 12:
Pleural Diseases
SECTION 13:
Chest Wall and Diaphragm
xiii
TABLE OF CONTENTS
26 Peribronchovascular
SECTION 1: OVERVIEW OF CHEST Santiago Martínez-Jiménez, MD
IMAGING 27 Perilobular Pattern
INTRODUCTION AND OVERVIEW Santiago Martínez-Jiménez, MD
28 Perilymphatic
4 Approach to Chest Imaging Santiago Martínez-Jiménez, MD
Melissa L. Rosado de Christenson, MD, FACR 29 Pneumatocele
Melissa L. Rosado de Christenson, MD, FACR
ILLUSTRATED TERMINOLOGY 30 Reticular Pattern
6 Approach to Illustrated Terminology Melissa L. Rosado de Christenson, MD, FACR
Melissa L. Rosado de Christenson, MD, FACR 31 Secondary Pulmonary Lobule
8 Acinar Nodules Melissa L. Rosado de Christenson, MD, FACR
Melissa L. Rosado de Christenson, MD, FACR and Tyler H. 32 Traction Bronchiectasis
Ternes, MD Melissa L. Rosado de Christenson, MD, FACR
9 Air Bronchogram 33 Tree-in-Bud Opacities
Tyler H. Ternes, MD Melissa L. Rosado de Christenson, MD, FACR
10 Air-Trapping
Tyler H. Ternes, MD CHEST RADIOGRAPHIC AND CT SIGNS
11 Airspace 34 Approach to Chest Radiographic and CT Signs
Tyler H. Ternes, MD Santiago Martínez-Jiménez, MD
12 Architectural Distortion 40 Air Crescent Sign
Tyler H. Ternes, MD Santiago Martínez-Jiménez, MD
13 Bulla/Bleb 41 Cervicothoracic Sign
Tyler H. Ternes, MD Santiago Martínez-Jiménez, MD
14 Cavity 42 Comet Tail Sign
Melissa L. Rosado de Christenson, MD, FACR Santiago Martínez-Jiménez, MD
15 Centrilobular 43 CT Halo Sign
Santiago Martínez-Jiménez, MD and Melissa L. Rosado de Santiago Martínez-Jiménez, MD
Christenson, MD, FACR 44 Deep Sulcus Sign
16 Consolidation Santiago Martínez-Jiménez, MD
Melissa L. Rosado de Christenson, MD, FACR 45 Fat Pad Sign
17 Cyst Santiago Martínez-Jiménez, MD
Melissa L. Rosado de Christenson, MD, FACR 46 Finger-in-Glove Sign
18 Ground-Glass Opacity Santiago Martínez-Jiménez, MD
Melissa L. Rosado de Christenson, MD, FACR 47 Hilum Convergence Sign
19 Honeycombing Santiago Martínez-Jiménez, MD
Santiago Martínez-Jiménez, MD 48 Hilum Overlay Sign
20 Interlobular Septal Thickening Santiago Martínez-Jiménez, MD
Melissa L. Rosado de Christenson, MD, FACR 49 Incomplete Border Sign
21 Intralobular Lines Santiago Martínez-Jiménez, MD
Melissa L. Rosado de Christenson, MD, FACR 50 Luftsichel Sign
22 Mass Santiago Martínez-Jiménez, MD
Melissa L. Rosado de Christenson, MD, FACR 51 Reversed Halo Sign
23 Miliary Pattern Santiago Martínez-Jiménez, MD
Melissa L. Rosado de Christenson, MD, FACR 52 Rigler and Cupola Signs
24 Mosaic Attenuation Santiago Martínez-Jiménez, MD
Melissa L. Rosado de Christenson, MD, FACR 53 S-Sign of Golden
25 Nodule Santiago Martínez-Jiménez, MD
Melissa L. Rosado de Christenson, MD, FACR 54 Signet Ring Sign
Santiago Martínez-Jiménez, MD
xiv
TABLE OF CONTENTS
55 Silhouette Sign
Santiago Martínez-Jiménez, MD
SYSTEMIC CIRCULATION
110 Accessory Azygos Fissure
ATELECTASIS AND VOLUME LOSS Sherief H. Garrana, MD
56 Approach to Atelectasis and Volume Loss 112 Azygos and Hemiazygos Continuation of the IVC
Melissa L. Rosado de Christenson, MD, FACR and Gerald F. Sherief H. Garrana, MD
Abbott, MD, FACR 116 Persistent Left Superior Vena Cava
60 Atelectasis Claudio Silva, MD, MSc, MBA
Tomás Franquet, MD, PhD 120 Aberrant Subclavian Artery
64 Cicatricial Atelectasis Sherief H. Garrana, MD
Brett W. Carter, MD, CPPS 122 Right Aortic Arch
65 Rounded Atelectasis Santiago Martínez-Jiménez, MD
Brett W. Carter, MD, CPPS 126 Double Aortic Arch
Carlos S. Restrepo, MD and Diane C. Strollo, MD, FACR
SECTION 2: DEVELOPMENTAL 130 Aortic Coarctation
ABNORMALITIES Tyler H. Ternes, MD and Santiago Martínez-Jiménez, MD
xv
TABLE OF CONTENTS
248 Infectious Bronchiolitis
MALIGNANT NEOPLASMS John P. Lichtenberger, III, MD and Laura E. Heyneman, MD
178 Squamous Cell Carcinoma, Airways 252 Constrictive Bronchiolitis
Sonia L. Betancourt-Cuellar, MD Brett W. Carter, MD, CPPS
182 Adenoid Cystic Carcinoma 256 Swyer-James-MacLeod Syndrome
Sonia L. Betancourt-Cuellar, MD Allen Heeger, DO
186 Mucoepidermoid Carcinoma 260 Asthma
Sonia L. Betancourt-Cuellar, MD Carlos S. Restrepo, MD and Santiago Martínez-Jiménez,
190 Metastasis, Airways MD
Sonia L. Betancourt-Cuellar, MD
SECTION 4: INFECTIONS
AIRWAY NARROWING AND WALL
THICKENING INTRODUCTION AND OVERVIEW
192 Saber-Sheath Trachea 266 Approach to Infections
Brett W. Carter, MD, CPPS Santiago Martínez-Jiménez, MD
194 Tracheal Stenosis
Aletta Ann Frazier, MD GENERAL
196 Tracheobronchomalacia 268 Bronchopneumonia
Aletta Ann Frazier, MD Sherief H. Garrana, MD
200 Middle Lobe Syndrome 270 Community-Acquired Pneumonia
Santiago Martínez-Jiménez, MD Claudio Silva, MD, MSc, MBA and Jeffrey P. Kanne, MD
206 Airway Granulomatosis With Polyangiitis 274 Hospital-Acquired Pneumonia
Jorge Alberto Carrillo-Bayona, MD Jorge Alberto Carrillo-Bayona, MD
208 Tracheobronchial Amyloidosis 276 Lung Abscess
John P. Lichtenberger, III, MD and Jeffrey P. Kanne, MD Carlos S. Restrepo, MD and Helen T. Winer-Muram, MD
210 Tracheobronchopathia Osteochondroplastica 280 Septic Emboli
Sonia L. Betancourt-Cuellar, MD John P. Lichtenberger, III, MD and Carol C. Wu, MD
212 Relapsing Polychondritis
Jorge Alberto Carrillo-Bayona, MD BACTERIA
214 Rhinoscleroma 284 Pneumococcal Pneumonia
Jorge Alberto Carrillo-Bayona, MD Jorge Alberto Carrillo-Bayona, MD
288 Staphylococcal Pneumonia
BRONCHIAL DILATATION AND IMPACTION
Jorge Alberto Carrillo-Bayona, MD
216 Bronchitis 292 Klebsiella Pneumonia
Carlos S. Restrepo, MD and Carol C. Wu, MD Jorge Alberto Carrillo-Bayona, MD
218 Bronchiectasis 294 Pseudomonas Pneumonia
Sherief H. Garrana, MD and Laura E. Heyneman, MD Sherief H. Garrana, MD
222 Cystic Fibrosis 296 Legionella Pneumonia
Aletta Ann Frazier, MD Carlos S. Restrepo, MD and Jeffrey P. Kanne, MD
226 Allergic Bronchopulmonary Aspergillosis 298 Nocardiosis
Allen Heeger, DO Carlos S. Restrepo, MD and Helen T. Winer-Muram, MD
230 Primary Ciliary Dyskinesia 300 Actinomycosis
Melissa L. Rosado de Christenson, MD, FACR and Carlos S. Carlos S. Restrepo, MD and Tomás Franquet, MD, PhD
Restrepo, MD 302 Melioidosis
234 Mounier-Kuhn Syndrome Jorge Alberto Carrillo-Bayona, MD
Sonia L. Betancourt-Cuellar, MD and Carlos S. Restrepo, 304 Tuberculosis
MD Melissa L. Rosado de Christenson, MD, FACR
236 Williams-Campbell Syndrome 308 Nontuberculous Mycobacterial Infection
Sonia L. Betancourt-Cuellar, MD Kyung Soo Lee, MD
238 Broncholithiasis 312 Mycoplasma Pneumonia
Santiago Martínez-Jiménez, MD Jorge Alberto Carrillo-Bayona, MD
xvi
TABLE OF CONTENTS
320 Cytomegalovirus Pneumonia
Carol C. Wu, MD and Carlos S. Restrepo, MD
UNCOMMON NEOPLASMS
324 COVID-19 398 Pulmonary Hamartoma
Santiago Martínez-Jiménez, MD and Sherief H. Garrana, Allen Heeger, DO
MD 402 Bronchial Carcinoid
Sonia L. Betancourt-Cuellar, MD
FUNGI 406 Neuroendocrine Carcinoma
328 Histoplasmosis Cristina Fuss, MD and Sonia L. Betancourt-Cuellar, MD
Carlos S. Restrepo, MD and Helen T. Winer-Muram, MD 410 Kaposi Sarcoma
332 Coccidioidomycosis Carlos S. Restrepo, MD and Brett W. Carter, MD, CPPS
Carlos S. Restrepo, MD and Diane C. Strollo, MD, FACR
334 Blastomycosis
LYMPHOMA AND LYMPHOPROLIFERATIVE
Carlos S. Restrepo, MD and Diane C. Strollo, MD, FACR
DISORDERS
336 Cryptococcosis 414 Follicular Bronchiolitis
Brett W. Carter, MD, CPPS Jorge Alberto Carrillo-Bayona, MD
338 Paracoccidioidomycosis 418 Lymphoid Interstitial Pneumonia
Jorge Alberto Carrillo-Bayona, MD Jorge Alberto Carrillo-Bayona, MD
340 Aspergillosis 422 Nodular Lymphoid Hyperplasia
Allen Heeger, DO Santiago Martínez-Jiménez, MD
346 Zygomycosis 424 Post-Transplant Lymphoproliferative Disease
Sonia L. Betancourt-Cuellar, MD John P. Lichtenberger, III, MD and Christopher M. Walker,
348 Pneumocystis jirovecii Pneumonia MD
Sherief H. Garrana, MD 428 Pulmonary Lymphoma
Sonia L. Betancourt-Cuellar, MD
PARASITES
352 Dirofilariasis
METASTATIC DISEASE
Carlos S. Restrepo, MD and Tomás Franquet, MD, PhD 432 Hematogenous Metastases
354 Hydatidosis Aletta Ann Frazier, MD
Carlos S. Restrepo, MD and Tomás Franquet, MD, PhD 436 Lymphangitic Carcinomatosis
356 Strongyloidiasis Sonia L. Betancourt-Cuellar, MD
Carlos S. Restrepo, MD and Brett W. Carter, MD, CPPS 440 Tumor Emboli
358 Amebiasis Carlos S. Restrepo, MD and Florian J. Fintelmann, MD,
Carlos S. Restrepo, MD FRCPC
362 Schistosomiasis
Carlos S. Restrepo, MD SECTION 6: INTERSTITIAL, DIFFUSE, AND
INHALATIONAL LUNG DISEASE
SECTION 5: PULMONARY NEOPLASMS
INTRODUCTION AND OVERVIEW
INTRODUCTION AND OVERVIEW 446 Approach to Interstitial, Diffuse, and Inhalational
366 Approach to Pulmonary Neoplasms Lung Disease
Melissa L. Rosado de Christenson, MD, FACR Santiago Martínez-Jiménez, MD
xvii
TABLE OF CONTENTS
548 Dendriform Pulmonary Ossification
SMOKING-RELATED DISEASES Jorge Alberto Carrillo-Bayona, MD
474 Respiratory Bronchiolitis and RBILD
Jorge Alberto Carrillo-Bayona, MD SECTION 7: CONNECTIVE TISSUE
476 Desquamative Interstitial Pneumonia DISORDERS, IMMUNOLOGICAL
Jorge Alberto Carrillo-Bayona, MD DISEASES, AND VASCULITIS
480 Pulmonary Langerhans Cell Histiocytosis
Tyler H. Ternes, MD INTRODUCTION AND OVERVIEW
484 Combined Pulmonary Fibrosis and Emphysema 552 Approach to Connective Tissue Disorders,
Aletta Ann Frazier, MD Immunological Diseases, and Vasculitis
Santiago Martínez-Jiménez, MD
PNEUMOCONIOSIS
486 Asbestosis IMMUNOLOGICAL AND CONNECTIVE TISSUE
Carlos S. Restrepo, MD and Helen T. Winer-Muram, MD DISORDERS
490 Silicosis and Coal Worker's Pneumoconiosis 554 Interstitial Pneumonia With Autoimmune Features
Brett W. Carter, MD, CPPS and Julia Alegría, MD (IPAF)
494 Hard Metal Pneumoconiosis Santiago Martínez-Jiménez, MD
Carlos S. Restrepo, MD 558 Rheumatoid Arthritis
496 Berylliosis Sonia L. Betancourt-Cuellar, MD
Sonia L. Betancourt-Cuellar, MD 562 Scleroderma
500 Silo-Filler's Disease Julia Alegría, MD and Jonathan Hero Chung, MD
Tyler H. Ternes, MD 566 Mixed Connective Tissue Disease
Julia Alegría, MD and Laura E. Heyneman, MD
OTHER INHALATIONAL DISORDERS 568 Polymyositis/Dermatomyositis
502 Hypersensitivity Pneumonitis Julia Alegría, MD and Carlos S. Restrepo, MD
Julia Alegría, MD 572 Systemic Lupus Erythematosus
506 Smoke Inhalation Julia Alegría, MD and Laura E. Heyneman, MD
John P. Lichtenberger, III, MD and Terrance Healey, MD 576 Sjögren Syndrome
510 E-Cigarette or Vaping Product Use-Associated Lung Sonia L. Betancourt-Cuellar, MD
Injury (EVALI) 582 Ankylosing Spondylitis
Carlos S. Restrepo, MD Tyler H. Ternes, MD
512 Aspiration 586 Inflammatory Bowel Disease
Carlos S. Restrepo, MD Sonia L. Betancourt-Cuellar, MD
516 Excipient Lung Disease 590 Erdheim-Chester Disease
Santiago Martínez-Jiménez, MD Carlos S. Restrepo, MD
xviii
TABLE OF CONTENTS
620 Behçet Syndrome 688 Coronary Artery Aneurysm
Aletta Ann Frazier, MD Julia Alegría, MD and John P. Lichtenberger, III, MD
622 Necrotizing Sarcoid Granulomatosis 690 Paraesophageal Varices
Aletta Ann Frazier, MD John P. Lichtenberger, III, MD
692 Mediastinal Lymphangioma
SECTION 8: MEDIASTINAL Aletta Ann Frazier, MD
ABNORMALITIES 694 Mediastinal Hemangioma
Aletta Ann Frazier, MD
INTRODUCTION AND OVERVIEW
626 Approach to Mediastinal Abnormalities GLANDULAR ENLARGEMENT
Melissa L. Rosado de Christenson, MD, FACR 696 Thymic Hyperplasia
Santiago Martínez-Jiménez, MD
PRIMARY NEOPLASMS 700 Mediastinal Goiter
630 Thymoma Santiago Martínez-Jiménez, MD
Melissa L. Rosado de Christenson, MD, FACR
634 Thymic Neuroendocrine Neoplasm DISEASES OF THE ESOPHAGUS
Sherief H. Garrana, MD 704 Achalasia
636 Thymic Carcinoma Julia Alegría, MD
Sherief H. Garrana, MD 706 Esophageal Diverticula
638 Thymolipoma Julia Alegría, MD and Tomás Franquet, MD, PhD
Melissa L. Rosado de Christenson, MD, FACR 708 Esophageal Stricture
640 Mediastinal Teratoma Claudio Silva, MD, MSc, MBA and Santiago Martínez-
John P. Lichtenberger, III, MD Jiménez, MD
644 Mediastinal Seminoma 710 Esophageal Carcinoma
Aletta Ann Frazier, MD Sonia L. Betancourt-Cuellar, MD
646 Nonseminomatous Malignant Germ Cell Neoplasm
Aletta Ann Frazier, MD MISCELLANEOUS CONDITIONS
648 Neurogenic Neoplasms of the Nerve Sheath 714 Mediastinal Lipomatosis
Sherief H. Garrana, MD Claudio Silva, MD, MSc, MBA
652 Neurogenic Neoplasms of the Sympathetic Ganglia 716 Mediastinitis
John P. Lichtenberger, III, MD Claudio Silva, MD, MSc, MBA
654 Neurofibromatosis 720 Mediastinal Fat Necrosis
Sonia L. Betancourt-Cuellar, MD Allen Heeger, DO
724 Extramedullary Hematopoiesis
LYMPHADENOPATHY
Claudio Silva, MD, MSc, MBA and Santiago Martínez-
656 Metastatic Disease, Lymphadenopathy Jiménez, MD
Brett W. Carter, MD, CPPS 726 Hiatal Hernia
660 Mediastinal Lymphoma Tyler H. Ternes, MD
Sherief H. Garrana, MD
664 Fibrosing Mediastinitis SECTION 9: CARDIOVASCULAR
Sherief H. Garrana, MD DISORDERS
668 Castleman Disease
Brett W. Carter, MD, CPPS INTRODUCTION AND OVERVIEW
732 Approach to Cardiovascular Disorders
CYSTS Santiago Martínez-Jiménez, MD
672 Bronchogenic Cyst
Aletta Ann Frazier, MD DISEASES OF THE AORTA AND GREAT
676 Esophageal Duplication Cyst VESSELS
Aletta Ann Frazier, MD 736 Atherosclerosis
678 Pericardial Cyst Carlos S. Restrepo, MD and Santiago Martínez-Jiménez,
Aletta Ann Frazier, MD MD
682 Thymic Cyst 740 Aortic Aneurysm
Aletta Ann Frazier, MD Carlos S. Restrepo, MD and Santiago Martínez-Jiménez,
MD
VASCULAR LESIONS
742 Acute Aortic Syndromes
684 Mediastinal Vascular Masses Santiago Martínez-Jiménez, MD and Julia Alegría, MD
Brett W. Carter, MD, CPPS
xix
TABLE OF CONTENTS
748 Marfan Syndrome 820 Cardiac Myxoma
Claudio Silva, MD, MSc, MBA and Santiago Martínez- John P. Lichtenberger, III, MD
Jiménez, MD 824 Cardiac Sarcoma
750 Takayasu Arteritis Brett W. Carter, MD, CPPS
Brett W. Carter, MD, CPPS 826 Pulmonary Artery Sarcoma
752 Superior Vena Cava Obstruction Brett W. Carter, MD, CPPS
Allen Heeger, DO 828 Aortic Sarcoma
John P. Lichtenberger, III, MD
PULMONARY EDEMA
756 Pulmonary Edema SECTION 10: TRAUMA
Melissa L. Rosado de Christenson, MD, FACR INTRODUCTION AND OVERVIEW
PULMONARY HYPERTENSION AND 832 Approach to Chest Trauma
THROMBOEMBOLIC DISEASE Melissa L. Rosado de Christenson, MD, FACR
762 Pulmonary Artery Hypertension AIRWAYS AND LUNG
Brett W. Carter, MD, CPPS
766 Pulmonary Venoocclusive Disease/Pulmonary 834 Tracheobronchial Laceration
Capillary Hemangiomatosis Cristina Fuss, MD and Terrance Healey, MD
Claudio Silva, MD, MSc, MBA 836 Lung Trauma
768 Acute Pulmonary Thromboembolic Disease Allen Heeger, DO
Allen Heeger, DO
772 Chronic Pulmonary Thromboembolic Disease
CARDIOVASCULAR/MEDIASTINUM
Carlos S. Restrepo, MD and Helen T. Winer-Muram, MD 840 Pneumomediastinum
776 Sickle Cell Disease John P. Lichtenberger, III, MD
Aletta Ann Frazier, MD 844 Traumatic Aortic Injury
780 Fat Embolism Allen Heeger, DO
Brett W. Carter, MD, CPPS 848 Esophageal Perforation
782 Hepatopulmonary Syndrome John P. Lichtenberger, III, MD and Diane C. Strollo, MD,
John P. Lichtenberger, III, MD FACR
784 Illicit Drug Use, Pulmonary Manifestations 852 Thoracic Duct Tear
Tyler H. Ternes, MD and Carol C. Wu, MD Allen Heeger, DO
DISEASES OF THE HEART AND PERICARDIUM PLEURA, CHEST WALL, AND DIAPHRAGM
786 Valve and Annular Calcification 854 Traumatic Pneumothorax
Brett W. Carter, MD, CPPS Allen Heeger, DO
790 Aortic Valve Disease 856 Traumatic Hemothorax
Brett W. Carter, MD, CPPS Allen Heeger, DO
794 Mitral Valve Disease 858 Thoracic Splenosis
Claudio Silva, MD, MSc, MBA and John P. Lichtenberger, Allen Heeger, DO
III, MD 860 Rib Fractures and Flail Chest
798 Left Atrial Calcification Cristina Fuss, MD and Jonathan Hero Chung, MD
Claudio Silva, MD, MSc, MBA 864 Spinal Fracture
800 Ventricular Calcification John P. Lichtenberger, III, MD
Claudio Silva, MD, MSc, MBA and Brett W. Carter, MD, 866 Sternal Fracture
CPPS John P. Lichtenberger, III, MD
802 Coronary Artery Calcification 868 Diaphragmatic Rupture
Claudio Silva, MD, MSc, MBA and Brett W. Carter, MD, Cristina Fuss, MD and Jonathan Hero Chung, MD
CPPS
806 Post Cardiac Injury Syndrome SECTION 11: POST-TREATMENT CHEST
Claudio Silva, MD, MSc, MBA
808 Pericardial Effusion
INTRODUCTION AND OVERVIEW
Cristina Fuss, MD 874 Approach to Post-Treatment Chest
814 Constrictive Pericarditis Santiago Martínez-Jiménez, MD
John P. Lichtenberger, III, MD
LIFE SUPPORT DEVICES
CARDIOVASCULAR NEOPLASMS 876 Endotracheal and Enteric Tubes
816 Cardiac and Pericardial Metastases Cristina Fuss, MD
John P. Lichtenberger, III, MD
xx
TABLE OF CONTENTS
880 Chest Tubes and Drains 958 Chylothorax
Cristina Fuss, MD Claudio Silva, MD, MSc, MBA
884 Vascular Catheters 960 Empyema
Cristina Fuss, MD Julia Alegría, MD and Jonathan Hero Chung, MD
890 Cardiac Conduction Devices
Cristina Fuss, MD PNEUMOTHORAX
964 Iatrogenic Pneumothorax
SURGICAL PROCEDURES AND Cristina Fuss, MD
COMPLICATIONS 966 Primary Spontaneous Pneumothorax
894 Pleurodesis Cristina Fuss, MD
John P. Lichtenberger, III, MD and Florian J. Fintelmann, 970 Secondary Spontaneous Pneumothorax
MD, FRCPC Cristina Fuss, MD
896 Sublobar Resection
Allen Heeger, DO PLEURAL THICKENING
898 Lung Volume Reduction Surgery 974 Apical Cap
John P. Lichtenberger, III, MD and Carol C. Wu, MD John P. Lichtenberger, III, MD
900 Lobectomy 976 Pleural Plaques
Brett W. Carter, MD, CPPS Allen Heeger, DO
904 Lobar Torsion 980 Pleural Fibrosis and Fibrothorax
Cristina Fuss, MD and Jeffrey P. Kanne, MD Allen Heeger, DO
906 Pneumonectomy
Allen Heeger, DO NEOPLASIA
912 Thoracoplasty and Apicolysis 982 Malignant Pleural Effusion
Julia Alegría, MD and Jeffrey P. Kanne, MD Allen Heeger, DO
914 Lung Herniation 984 Solid Pleural Metastases
Cristina Fuss, MD and Jeffrey P. Kanne, MD Melissa L. Rosado de Christenson, MD, FACR
916 Sternotomy 986 Malignant Pleural Mesothelioma
John P. Lichtenberger, III, MD and Diane C. Strollo, MD, Brett W. Carter, MD, CPPS
FACR 990 Localized Fibrous Tumor of the Pleura
920 Heart Transplantation Melissa L. Rosado de Christenson, MD, FACR
John P. Lichtenberger, III, MD
924 Lung Transplantation SECTION 13: CHEST WALL AND
Cristina Fuss, MD and Jeffrey P. Kanne, MD DIAPHRAGM
928 Esophageal Resection
Julia Alegría, MD and Tomás Franquet, MD, PhD INTRODUCTION AND OVERVIEW
RADIATION, CHEMOTHERAPY, ABLATION 996 Approach to Chest Wall and Diaphragm
Melissa L. Rosado de Christenson, MD, FACR
930 Radiation-Induced Lung Disease
Sonia L. Betancourt-Cuellar, MD CHEST WALL
936 Drug Reaction, Intrathoracic 998 Chest Wall Infections
Sonia L. Betancourt-Cuellar, MD John P. Lichtenberger, III, MD
940 Ablation Procedures 1000 Discitis
Sonia L. Betancourt-Cuellar, MD Julia Alegría, MD
1002 Chest Wall Lipoma and Liposarcoma
SECTION 12: PLEURAL DISEASES Brett W. Carter, MD, CPPS
INTRODUCTION AND OVERVIEW 1006 Elastofibroma and Fibromatosis
Brett W. Carter, MD, CPPS
946 Approach to Pleural Diseases 1010 Chest Wall Metastases
Melissa L. Rosado de Christenson, MD, FACR Claudio Silva, MD, MSc, MBA
1014 Chondrosarcoma
EFFUSION
Sonia L. Betancourt-Cuellar, MD
948 Transudative Pleural Effusion 1016 Plasmacytoma and Multiple Myeloma
Claudio Silva, MD, MSc, MBA Brett W. Carter, MD, CPPS
952 Exudative Pleural Effusion
Claudio Silva, MD, MSc, MBA DIAPHRAGM
956 Hemothorax 1018 Diaphragmatic Eventration
Claudio Silva, MD, MSc, MBA Santiago Martínez-Jiménez, MD
1020 Diaphragmatic Paralysis
Santiago Martínez-Jiménez, MD
xxi
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THIRD EDITION
Rosado-de-Christenson
Martínez-Jiménez
Restrepo | Betancourt-Cuellar
Carter | Lichtenberger
Heeger | Ternes
Carrillo-Bayona | Frazier
Silva | Garrana
Alegría | Fuss
SECTION 1
Illustrated Terminology
Approach to Illustrated Terminology 6
Acinar Nodules 8
Air Bronchogram 9
Air-Trapping 10
Airspace 11
Architectural Distortion 12
Bulla/Bleb 13
Cavity 14
Centrilobular 15
Consolidation 16
Cyst 17
Ground-Glass Opacity 18
Honeycombing 19
Interlobular Septal Thickening 20
Intralobular Lines 21
Mass 22
Miliary Pattern 23
Mosaic Attenuation 24
Nodule 25
Peribronchovascular 26
Perilobular Pattern 27
Perilymphatic 28
Pneumatocele 29
Reticular Pattern 30
Secondary Pulmonary Lobule 31
Traction Bronchiectasis 32
Tree-in-Bud Opacities 33
6
Approach to Illustrated Terminology
7
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The Project Gutenberg eBook of Journal et
fragments
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eBook.
Editor: G. S. Trébutien
Language: French
G. S. TREBUTIEN
Conservateur-adjoint de la Bibliothèque de Caen
TREIZIÈME ÉDITION
PARIS
LIBRAIRIE ACADÉMIQUE
M DCCC LXV
Tous droits réservés.
A LA MÊME LIBRAIRIE
LETTRES INÉDITES
D’EUGÉNIE DE GUÉRIN
PUBLIÉES PAR M. TREBUTIEN
DEUXIÈME ÉDITION
1 vol. in-12. — 3 fr. 50
MAURICE DE GUÉRIN
JOURNAL, LETTRES ET FRAGMENTS, POÈMES
SEPTIÈME ÉDITION
1 vol. in-12. — 3 fr. 50
Mlle Eugénie de Guérin était née cinq ans avant son frère. Elle a
eu la douleur de lui survivre près de neuf ans, jusqu’au jour où elle
s’éteignit dans sa solitude du Cayla, le 31 mai 1848.
Nous ne raconterons pas sa vie. Ce qui en fait l’intérêt, ce sont
ses pensées et la façon dont elle les exprime. Du reste, cette vie est
si simple qu’un voyage à Alby ou à Toulouse, deux courts séjours
dans le Nivernais et à Paris, y ont fait époque. Un départ ou un
retour, les maladies de ceux qui lui sont chers, le mariage et la mort
de son plus jeune frère en ont été les véritables événements. Sur
tout ce qui la touche et les émotions qu’elle a ressenties, son Journal
et ses lettres ne nous ont rien laissé à dire qui vaille la peine d’être
dit.
Il est vrai que le seul projet de livrer à tout le monde ces lettres,
ce Journal surtout, a dû éveiller chez une sœur, pieuse dépositaire
de ce mystique héritage, des scrupules auxquels nous avons eu
nous-même quelque peine à nous soustraire. Combien de fois notre
attention ne s’est-elle pas fixée avec une sorte d’anxiété sur ces
paroles adressées par Mlle de Guérin à son cahier qu’elle dérobait
avec tant de soin à tous les regards : « Ceci n’est pas pour le public ;
c’est de l’intime, de l’âme, C’EST POUR UN [4] . »
[4] Page 91.
Lui assurer cette gloire était son vœu. Jamais Mlle de Guérin
n’avait prétendu la partager. Il en sera pourtant ainsi. Et Maurice
aurait été le premier à trouver que cela était juste. En vain sa sœur
essaye-t-elle de lutter contre l’inspiration qui la sollicite et de
s’effacer devant lui : il envie à ce poëte qui veut se taire, à ce poëte
malgré lui la fécondité de sa pensée, l’originalité de son langage :
« Oh ! lui dit-il, si j’étais toi ! » En effet, c’est elle qui avait le plus reçu
de la nature. A peine a-t-elle connu les langueurs de l’épuisement
qui arrachent à Maurice des plaintes si pénétrantes ; dans ce qu’elle
écrit, jamais d’effort. « Je ne sais, avoue-t-elle quelque part, pourquoi
il est en moi d’écrire comme à la fontaine de couler. » Facilité qui
semble excessive lorsqu’on lit ses vers ; dans cette langue, il lui a
manqué, comme à son frère, et plus encore, de savoir se borner et
revenir sur les négligences de l’improvisation. Mais ce libre jet donne
à sa prose, précise et nerveuse, un relief et une ingénuité dont on
est saisi. Elle a l’énergie et la grâce, le don de dire simplement
toutes choses, et de s’élever des plus petites, par un mouvement
naturel, aux plus hautes ; elle est tour à tour et tout à la fois familière,
enjouée, naïve, profonde et sublime. L’étude et l’art n’ont guère
passé par là ; on le sent même à quelques termes singuliers, à
quelques expressions étranges, qui seraient ailleurs autant de
taches, qui sont ici comme un reste d’accent, le goût du terroir, le
parfum de la solitude. Aussi n’avons-nous point songé à les effacer.
Le Journal de Mlle de Guérin n’est malheureusement pas
complet. Trois cahiers ne nous sont point parvenus : ils ont été
égarés sans doute avec toutes les lettres adressées par la sœur à
son frère. Nous publions les douze autres cahiers tels qu’ils ont été
remis en nos mains par M. Auguste Raynaud au nom de Mlle Marie
de Guérin, qui nous permettra de lui témoigner ici notre éternelle
reconnaissance pour la haute confiance dont elle nous a honoré.
Nous en avons seulement réservé, pour nous conformer au juste
désir de la famille, un petit nombre de passages d’ailleurs très courts
et d’un médiocre intérêt littéraire, où des personnes qui vivent
encore étaient désignées trop directement, et qu’il sera facile de
rétablir dans les éditions postérieures, dès qu’on le pourra sans
blesser les convenances.
D. et Cie.
Janvier 1864.
JOURNAL
DE
EUGÉNIE DE GUÉRIN
(Novembre 1834-Octobre 1841)
I
Le 17. — Trois lettres depuis hier, trois plaisirs bien grands, car
j’aime tant les lettres et celles qui m’écrivent : c’est Louise, Mimi et
Félicité. Cette chère Mimi me dit de charmantes et douces choses
sur notre séparation, sur son retour, sur son ennui, car elle s’ennuie
loin de moi comme je m’ennuie sans elle. A tout moment, je vois, je
sens qu’elle me manque, surtout la nuit où j’ai l’habitude de
l’entendre respirer à mon oreille. Ce petit bruit me porte sommeil. Ne
pas l’entendre me fait penser tristement. Je pense à la mort, qui fait
aussi tout taire autour de nous, qui sera aussi une absence. Ces
idées de la nuit me viennent un peu de celles du jour. On ne parle
que maladies, que morts ; la cloche d’Andillac n’a sonné que des
glas ces jours-ci. C’est la fièvre maligne qui fait ses ravages comme
tous les ans. Nous pleurons tous une jeune femme de ton âge, la
plus belle, la plus vertueuse de la paroisse, enlevée en quelques
jours. Elle laisse un tout petit enfant qui tétait. Pauvre petit ! C’était
Marianne de Gaillard. Dimanche dernier j’allai encore serrer la main
à une agonisante de dix-huit ans. Elle me reconnut, la pauvre jeune
fille, me dit un mot et se remit à prier Dieu. Je voulais lui parler, je ne
sus que lui dire ; les mourants parlent mieux que nous. On l’enterrait
lundi. Que de réflexions à faire sur ces tombes fraîches ! O mon
Dieu, que l’on s’en va vite de ce monde ! Le soir, quand je suis
seule, toutes ces figures de morts me reviennent. Je n’ai pas peur,
mais mes pensées prennent toutes le deuil, et le monde me paraît
aussi triste qu’un tombeau. Je t’ai dit cependant que ces lettres
m’avaient fait plaisir. Oh ! c’est bien vrai ; mon cœur n’est pas muet
au milieu de ces agonies, et ne sent que plus vivement tout ce qui lui
porte vie. Ta lettre donc m’a donné une lueur de joie, je me trompe,
un véritable bonheur, par les bonnes choses dont elle est remplie.
Enfin ton avenir commence à poindre ; je te vois un état, une
position sociale, un point d’appui à la vie matérielle. Dieu soit loué !
c’est ce que je désirais le plus en ce monde et pour toi et pour moi,
car mon avenir s’attache au tien, ils sont frères. J’ai fait de beaux
rêves à ce sujet, je te les dirai peut-être. Pour le moment, adieu ; il
faut que j’écrive à Mimi.