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Alberto Hidalgo

Publications and source records attributed to Alberto Hidalgo.

7 recordsLinked to original sources
PubMed2006

Smoking-related interstitial lung diseases: radiologic-pathologic correlation.

Smoking-related interstitial lung diseases (SRILD) are a heterogeneous group of entities of unknown cause. These diseases include desquamative interstitial pneumonia (DIP), respiratory-bronchiolitis-related interstitial lung disease (RB-ILD), pulmonary Langerhans' cell histiocytosis (LCH) and idiopathic pulmonary fibrosis (IPF). High-resolution CT is highly sensitive in the detection of abnormalities in the lung parenchyma and airways. Ground-glass attenuation can occur in DIP and RB-ILD. Whereas DIP is histologically characterized by intra-alveolar pigmented macrophages, RB-ILD shows alveolar macrophages in a patchy peribronchiolar distribution. LCH shows nodular infiltrates on histopathological examination containing varying amounts of characteristic Langerhans' histiocytes. The HRCT findings are characteristically bilateral, symmetrical and diffuse, involving the upper lobe zones with sparing of the costophrenic angles. The most prominent CT features are nodules (sometimes cavitary) measuring 1 to 10 mm in diameter, cysts and areas of ground-glass attenuation. Pathologically, IPF is characterized by its heterogeneity with areas of normal lung, alveolitis and end-stage fibrosis shown in the same biopsy specimen. High-resolution CT findings consist of honeycombing, traction bronchiectasis and intralobular interstitial thickening with subpleural and lower lung predominance. Since coexisting lesions in the same cases have been observed, a better understanding of the different smoking-related interstitial lung diseases (SRILD) allows a more confident and specific diagnosis.

Histiocytosis, Langerhans-Cell↗
PubMed2006

Thin-section CT findings in hematopoietic stem cell transplantation recipients with respiratory virus pneumonia.

OBJECTIVE: The purpose of this study was to use serial thin-section CT scans to assess the incidence of respiratory viral infection and lung abnormalities in a large patient population at high risk of pulmonary complications. MATERIALS AND METHODS: The study population consisted of 26 recipients of hematopoietic stem cell transplants who had proven respiratory viral pneumonia. In all cases, thin-section CT scans were obtained before fiberoptic bronchoscopy and bronchoalveolar lavage. The study included only patients in whom bronchoalveolar lavage fluid showed no evidence of organisms other than respiratory viruses. The CT scans were assessed for the presence, extent, and anatomic distribution of ground-glass attenuation, air-space consolidation, nodules, centrilobular branching structures (tree-in-bud), thickening of the bronchovascular bundles, and pleural effusion. RESULTS: Areas of ground-glass attenuation were identified in 24 (92%) of 26 patients and were the only finding in eight patients. Multiple nodules, seen in 17 (65%) of 26 patients, measured 3-10 mm in diameter or were larger than 10 mm. The nodules had a centrilobular or random distribution. A tree-in-bud appearance was seen in six of the patients with centrilobular nodules. This pattern had a bilateral distribution and involved mainly the lower lung zones. CT revealed thickening of the bronchovascular bundles in 16 (61%) of the patients. Thickening was bilateral in 14 and unilateral in two patients. Bronchial wall thickening involved the lower lobes in six patients and had a patchy random distribution in the remaining nine patients. Air-space consolidation was present in nine (35%) of the cases. It had a lobular or subsegmental distribution in eight of the patients and a segmental distribution in one patient. Areas of consolidation were randomly distributed throughout the lungs in all cases. Less common findings included bilateral pleural effusion and bronchial dilatation. CONCLUSION: Respiratory viral infection is common among adult recipients of hematopoietic stem cell transplants, occurring over a wide time span after transplantation. The presence of respiratory viral infection must be considered in any patient with new respiratory symptoms, fever, or findings at CT such as extensive or patchy areas of ground-glass opacities or a mixture of patterns, most commonly ground-glass attenuation, thickening of the bronchial walls, and multiple small nodules.

Adult↗
PubMed2005

Fractionated stereotactic radiotherapy boost for gynecologic tumors: an alternative to brachytherapy?

PURPOSE: A brachytherapy (BT) boost to the vaginal vault is considered standard treatment for many endometrial or cervical cancers. We aimed to challenge this treatment standard by using stereotactic radiotherapy (SRT) with a linac-based micromultileaf collimator technique. METHODS AND MATERIALS: Since January 2002, 16 patients with either endometrial (9) or cervical (7) cancer have been treated with a final boost to the areas at higher risk for relapse. In 14 patients, the target volume included the vaginal vault, the upper vagina, the parametria, or (if not operated) the uterus (clinical target volume [CTV]). In 2 patients with local relapse, the CTV was the tumor in the vaginal stump. Margins of 6-10 mm were added to the CTV to define the planning target volume (PTV). Hypofractionated dynamic-arc or intensity-modulated radiotherapy techniques were used. Postoperative treatment was delivered in 12 patients (2 x 7 Gy to the PTV with a 4-7-day interval between fractions). In the 4 nonoperated patients, a dose of 4 Gy/fraction in 5 fractions with 2 to 3 days' interval was delivered. Patients were immobilized in a customized vacuum body cast and optimally repositioned with an infrared-guided system developed for extracranial SRT. To further optimize daily repositioning and target immobilization, an inflated rectal balloon was used during each treatment fraction. In 10 patients, CT resimulation was performed before the last boost fraction to assess for repositioning reproducibility via CT-to-CT registration and to estimate PTV safety margins around the CTV. Finally, a comparative treatment planning study between BT and SRT was performed in 2 patients with an operated endometrial Stage I cancer. RESULTS: No patient developed severe acute urinary or low-intestinal toxicity. No patient developed urinary late effects (>6 months). One patient with a vaginal relapse previously irradiated to the pelvic region presented with Grade 3 rectal bleeding 18 months after retreatment. A second patient known to suffer from irritable bowel syndrome presented with Grade 1 abdominal pain after treatment. The estimated PTV margins around the CTV were 9-10 mm with infrared marker registration. External SRT succeeded in improving dose homogeneity to the PTV and in reducing the maximum dose to the rectum, when compared to BT. CONCLUSION: These results suggest that the use of external SRT to deliver a final boost to the areas at higher risk for relapse in endometrial or cervical cancer is feasible, well tolerated, and may well be considered an acceptable alternative to BT.

Adult↗
PubMed2004

Imaging of opportunistic fungal infections in immunocompromised patient.

Opportunistic fungal infection is a common cause of serious morbidity and mortality in the immunocompromised host. Combination of pattern recognition with knowledge of the clinical setting is the best approach to pulmonary infectious processes. The aim of this article is to assess the chest radiographs and CT imaging features of different opportunistic fungal infections in immunocompromised patients.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Subcutaneous nodules at the injection site of low-molecular-weight heparin: a mimic of metastatic disease at CT.

PURPOSE: To describe the appearance and prevalence of subcutaneous nodules in the anterior abdominal wall seen at CT in cancer patients receiving subcutaneous injections of low-molecular-weight heparin (LMWH). METHODS: CT examinations were reviewed in 426 patients receiving subcutaneous abdominal wall injections of LMWH for the presence of nodules. Nodules were evaluated for contour, maximal diameter, CT attenuation, and presence of hazy changes or air in the surrounding fat. RESULTS: Fourteen (3%) of the 426 patients had nodules attributable to subcutaneous injections of LMWH. Findings included poorly defined borders (100%), adjacent hazy soft tissue changes (100%), adjacent air (57%), and a mean CT attenuation of -4.4 HU (range: -50-40 HU). Three (0.7%) of 426 patients had nodules caused by metastatic disease. One (33%) nodule had poorly defined borders, two (67%) had surrounding hazy changes, one (33%) had air in adjacent tissue, and there was a mean CT attenuation of 44 HU (range: 14-140 HU). One (0.2%) patient had a subcutaneous nodule of uncertain etiology. CONCLUSION: Patients receiving subcutaneous injections of LMWH may develop nodules at the injection sites. Such nodules can resemble metastatic tumor deposits at CT, and careful correlation with clinical history and growth trends of metastatic deposits elsewhere in the patient is needed to avoid misdiagnosis.

Abdominal Muscles↗
PubMedDate not supplied

Human metapneumovirus infection in hematopoietic stem cell transplant recipients: high-resolution computed tomography findings.

PURPOSE: To review the high-resolution computed tomography (CT) findings in hematopoietic stem cell transplant (HCT) recipients who had proven human metapneumovirus (HMPV) pneumonia. MATERIALS AND METHODS: The study included 5 HCT recipients who had proven HMPV pneumonia. The patients included 4 men and 1 woman ranging in age from 23 to 58 years (mean age = 42 years). The CT scans were assessed for the presence, appearance, size, and distribution of parenchymal abnormalities. RESULTS: Human metapneumovirus was isolated in all 5 patients in this series. None of these patients had any other infectious organism identified in cultures or bronchoalveolar lavage. The predominant CT findings were bilateral abnormalities in all patients, consisting primarily of a mixture of patterns, including, most commonly, ground-glass attenuation and nodular opacities. Areas of ground-glass opacification had no zonal predominance and were bilateral, asymmetric, and patchily distributed. Multiple nodules were identified in 4 (80%) of 5 patients. Nodules were multiple; less than 5 nodules were identified in 1 case, and 5 to 10 nodules were identified in 3 cases. All nodules in all cases were less than 10 mm in diameter. Areas of air-space consolidation were identified in 2 (40%) patients. All patients were available for follow-up; lesions improved in 4 patients. CONCLUSION: The thin-section CT manifestations of HMPV pneumonia usually consist of a mixture of patterns, including, most commonly, ground-glass attenuation and nodular opacities.

Adult↗