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Thoracic Manifestations of Systemic Autoimmune Diseases: Radiographic and High-Resolution CT Findings¹

¹ From the Department of Radiology, Oregon Health Sciences University, 3181 SW Sam Jackson Park Rd, Mail Code L340, Portland, OR 97201 (J.P.M., S.L.P.); and the Department of Radiology, University of British Columbia and Vancouver Hospital and Health Sciences Centre, Vancouver, British Columbia, Canada (N.L.M.). Presented as a scientific exhibit at the 1999 RSNA scientific assembly. Received February 21, 2000; revision requested March 31 and received May 3; accepted May 4. Address correspondence to S.L.P. (e-mail: primacks@ohsu.edu).

The systemic autoimmune diseases include collagen vascular diseases, the systemic vasculitides, Wegener granulomatosis, and Churg-Strauss syndrome. They can cause a variety of thoracic abnormalities that are influenced by the pathophysiologic characteristics of the underlying disease process. Although many of the abnormalities can be detected at chest radiography, high-resolution computed tomography (CT) has been shown to be superior in depicting parenchymal, airway, and pleural abnormalities. Thoracic manifestations of collagen vascular diseases include pleural disease, pulmonary fibrosis, diaphragm weakness, aspiration pneumonia, bronchiolitis obliterans organizing pneumonia, bronchiolitis obliterans, and bronchiectasis. Wegener granulomatosis may be associated with multiple nodules or masses with irregular margins that are frequently cavitated. Patients with Churg-Strauss syndrome often have consolidation or ground-glass attenuation at chest radiography and CT. Goodpasture syndrome is associated with extensive bilateral air-space consolidation.

Index Terms: Arthritis, rheumatoid, 60.611 • Dermatomyositis, 60.614 • Lung, CT, 60.12118 • Lung, diseases, 60.61, 60.62, 60.691, 60.695 • Lupus erythematosus, 60.612 • Scleroderma, 60.613 • Spondylitis, 60.74 • Wegener granulomatosis, 60.622

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