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    Chest computed tomography showing bilateral nodules and consolidations, surrounded by ground-glass opacities, and resulting in a halo sign, with prevalent peribronchovascular distribution. Air bronchograms are bilaterally recognizable.

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    Volume-rendered three-dimensional reconstruction chest CT image shows the presence of bilateral opacities, with prevalent peribronchovascular distribution and sparing of the peripheral lung zones.

  • 1.

    Chung M 2020. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology 295: 202207.

  • 2.

    Zhou Z, Guo D, Li C, Fang Z, Chen L, Yang R, Li X, Zeng W, 2020. Coronavirus disease 2019: initial chest CT findings. Eur Radiol 2020: 19.

 

 

 

 

Peribronchial Consolidation with Surrounding Ground-Glass Opacity in COVID-19 Pneumonia: 3D Reconstruction of a Chest Computed Tomography

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  • 1 Department of Radiology, ASST Fatebenefratelli Sacco, Milan, Italy

A 54-year-old man presented with a 5-day fever, cough, dyspnea, and chest pain. Physical examination revealed bilateral crackles on lung auscultation; temperature was 39°C. C-reactive protein was 27.2 mg/L (normal range: 0–5 mg/L) and serum lactate level was 274 U/L (normal range: 135–225 U/L); other blood tests showed normal results. COVID-19 was detected in two oropharyngeal swab samples by RT-PCR on consecutive days; Legionella and Streptococcus pneumoniae urinary antigens and PCR for other respiratory viruses on nasopharyngeal swabs were all negative. A bronchoalveolar lavage excluded pulmonary aspergillosis. On day 3, the patient developed severe dyspnea with decreased oxygen saturation (90%). Unenhanced chest computed tomography (CT) imaging showed diffuse bilateral peribronchial consolidations surrounded by ground-glass opacities (Figures 1 and 2).

Figure 1.
Figure 1.

Chest computed tomography showing bilateral nodules and consolidations, surrounded by ground-glass opacities, and resulting in a halo sign, with prevalent peribronchovascular distribution. Air bronchograms are bilaterally recognizable.

Citation: The American Journal of Tropical Medicine and Hygiene 103, 1; 10.4269/ajtmh.20-0405

Figure 2.
Figure 2.

Volume-rendered three-dimensional reconstruction chest CT image shows the presence of bilateral opacities, with prevalent peribronchovascular distribution and sparing of the peripheral lung zones.

Citation: The American Journal of Tropical Medicine and Hygiene 103, 1; 10.4269/ajtmh.20-0405

The typical CT pattern of COVID-19 pneumonia consists of ground-glass opacities (GGO) with bilateral and peripheral distribution.1 However, less common imaging findings have also been reported. A pattern of peribronchial infiltrate with surrounding GGO is not well described in COVID-19, let alone to this extent.2 Radiologists should be aware of the wide spectrum of CT manifestation of this infection.

REFERENCES

  • 1.

    Chung M 2020. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology 295: 202207.

  • 2.

    Zhou Z, Guo D, Li C, Fang Z, Chen L, Yang R, Li X, Zeng W, 2020. Coronavirus disease 2019: initial chest CT findings. Eur Radiol 2020: 19.

Author Notes

Address correspondence to Michaela Cellina, Department of Radiology, ASST Fatebenefratelli Sacco, P.zza Principessa Clotilde, 3, Milan 20121, Italy. E-mail: michaela.cellina@asst-fbf-sacco.it

Authors’ addresses: Michaela Cellina, Marcello A. Orsi, and Giancarlo Olivamd, Department of Radiology, ASST Fatebenefratelli Sacco, Milan, Italy, E-mails: michaela.cellina@asst-fbf-sacco.it, marcello.orsi@asst-fbf-sacco.it, and linforisonanza@gmail.com.

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