Air crescent sign

Case contributed by A.Prof Frank Gaillard

Presentation

14 year-old female with acute myeloblastic leukaemia

Patient Data

Age: 14 years
CT

Sagittal reformat from a CT scan of the chest, performed on a 14 year-old female with acute myeloblastic leukaemia.

The image shows a rounded cavity in the apical right upper lobe, with a non-dependant soft-tissue nodule within it. There is some subtle ground-glass opacity surrounding the lesion. There were several other similar lesions in the right lung (not shown).

Case Discussion

The imaging features, combined with the clinical history, are characteristic of invasive fungal infection, most commonly due to Aspergillus spp.. Care should be taken to avoid confusion with mycetoma, which occurs in patients with  pre-existing lung cavities, is gravity-dependant, and lacks the ground-glass halo.

Invasive aspergillosis occurs in immunosuppressed individuals and carries a 65-90% mortality rate if improperly treated. Cavitation occurs in the recovery phase, and thus tends to indicate a better prognosis.

Reference: Abramson S. The Air-Crescent Sign. Radiology. 2001; 218:230-232

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Case information

rID: 8684
Case created: 22nd Feb 2010
Last edited: 31st Aug 2015
System: Chest
Inclusion in quiz mode: Included

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