Review
Imaging of the pulmonary manifestations of systemic disease
A G Rockall, D Rickards, P J ShawDepartment of
Radiology, University College London Hospitals, London, UK
Correspondence to: Dr A Rockall, Department of Academic Radiology, St Bartholomew's Hospital, Dominion House, St Bartholomew's Close, London EC1A 7BE, UK
Submitted 15 May
2000;
Accepted 6 March 2001
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Introduction |
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Lung involvement in systemic disease may be a manifestation of the underlying pathological process, may be a complication of the underlying disease or may be related to the treatment. Lung pathology is dominant in certain diseases, such as in Wegener's granulomatosis, but may be only rarely present, for example in Henoch-Schönlein purpura. However, lung involvement has a profound effect on prognosis and may be challenging to accurately diagnose. In some patients, bronchoalveolar lavage and tissue diagnosis with transbronchial or percutaneous biopsy is not possible, due to the poor clinical state of the patient.
Imaging often plays a central part when lung involvement is suspected clinically and this role has increased with the advent of high resolution computed tomography (HRCT). The chest radiograph may provide diagnostic information and be useful in follow up but it is relatively insensitive. HRCT now has several established roles:
(1) May be diagnostic and if not
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