Transient subpleural curvilinear shadow caused by pulmonary congestion

Our plain-English summary of Transient subpleural curvilinear shadow caused by pulmonary congestion, by K. Arai, T. Takashima, O. Matsui, et al (Journal of Computer Assisted Tomography, 1990).

The study

• Authors: K. Arai, T. Takashima, O. Matsui, M. Kadoya, R. Kamimura
• Journal: Journal of Computer Assisted Tomography
• Published: 1990;14(1):87-8
• Type of article: Case report
• Cited by: 12 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000001).

Abstract

We present two cases of transient subpleural curvilinear shadows (SCSs) on CT caused by pulmonary congestion. Subpleural curvilinear shadows, which are usually visible in the middle or lower dorsal lung field on CT, have been reported as the initial finding of pulmonary fibrosis. But SCS is not a specific finding since pulmonary congestion may be one cause of it.

In plain English

This article was a report of two patients, written by radiologists at Kanazawa University School of Medicine in Japan, whose CT scans showed a subpleural curvilinear shadow, a curved line just beneath the lung lining. The authors noted that earlier reports had described this shadow as a relatively characteristic finding in the early stage of pulmonary asbestosis or other lung diseases leading to fibrosis. Neither patient had a history of asbestos exposure. The first patient, a 66-year-old man with heart failure caused by aortic regurgitation, had the shadow in the lower back part of the lungs. Seven weeks later his heart failure had improved and the shadow had disappeared. The second patient, a 72-year-old woman being treated for uterine cervical cancer, had no clear shadow on her first CT. She developed it, along with pulmonary congestion, after kidney failure set in. When the kidney failure improved with treatment, the congestion and the shadow disappeared. The authors concluded that interstitial edema with pulmonary congestion was the cause of the shadow, that it may be reversible, and that it is not a specific sign of fibrosis.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (two cases)
• Who was studied: Two patients: a 66-year-old man admitted for fever and heart failure caused by aortic regurgitation, and a 72-year-old woman admitted for treatment of uterine cervical cancer. The authors were at the Department of Radiology, Kanazawa University School of Medicine, Japan. Dates are not given.
• Exposure: Neither patient had a history of asbestos exposure. The condition studied was pulmonary congestion: from heart failure in case 1, and from renal failure in case 2.
• Main results:
  • Case 1 (66-year-old man): CT showed the subpleural curvilinear shadow in the lower dorsal lung field.
  • Case 1: after his heart failure improved (seven weeks later, per the text), the shadow had disappeared on CT at the same level.
  • Case 2 (72-year-old woman): the first CT showed lung metastasis and a small pleural effusion but no clear shadow. After renal failure developed, imaging showed cardiomegaly, increased pleural effusion, pulmonary congestion, and the shadow.
  • Case 2: after the renal failure improved with radiation and anticancer drugs, the pleural effusion and pulmonary congestion disappeared on chest X-ray, and the shadow disappeared on CT.
• The authors' conclusion: The authors concluded that interstitial edema with pulmonary congestion is the cause of the subpleural curvilinear shadow in these cases. They concluded that the shadow may be reversible and is not a specific finding of pulmonary fibrosis.

Topics

Medical terms in this study, explained in our Lexicon: Subpleural Curvilinear Line, Pulmonary Fibrosis.

Related studies

• Pulmonary asbestosis: CT study of subpleural curvilinear shadow. Work in progress — H. Yoshimura, M. Hatakeyama, et al. (1986)
• CT patterns of pleuro-pulmonary damage caused by inhalation of pumice as a model of pneumoconiosis from non-fibrous amorphous silicates — C. Costa, G. Ascenti, et al. (2016)
• Causes of pulmonary impairment in asbestos-exposed individuals with diffuse pleural thickening — S.T. Kee, G. Gamsu, et al. (1996)
• Findings from high resolution computed tomography of the lung and pleura of symptom free workers exposed to amosite who had normal chest radiographs and pulmonary function tests — S. Neri, A. Antonelli, et al. (1994)
• Pulmonary abnormalities as a result of exposure to Libby amphibole during childhood and adolescence-The Pre-Adult Latency Study (PALS) — J. Szeinuk, C.W. Noonan, et al. (2017)
• Libby Amphibole Disease: Pulmonary Function and CT Abnormalities in Vermiculite Miners — A. Miller, J. Szeinuk, et al. (2018)

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