Cartilaginous disorders of the chest.
Meyer CA, White CS
Cartilaginous disorders of the thorax can arise in the parenchyma, airways,
chest wall, and axial skeleton. At radiography, pulmonary hamartoma is
characterized by "popcorn" calcification or fat density, either of which
is diagnostic. Bronchiectasis is best demonstrated at high-resolution computed
tomography (CT) and has a "tramline" or "signet ring" appearance. Tracheopathia
osteochondroplastica appears at CT as multiple sessile submucosal nodules
with or without calcification along the cartilaginous portion of the trachea.
In relapsing polychondritis, the trachea and mainstem bronchi have diffuse
or focal thickening with luminal narrowing at radiography. Costochondritis
of the chest wall has become more prevalent with increased intravenous
drug abuse and may be demonstrated at CT as soft-tissue swelling along
with underlying cartilaginous fragmentation and bone destruction. Enchondromas
are expansile and may display a calcified cartilaginous matrix at radiography.
In osteochondroma, the thickness of the cartilaginous cap determines the
likelihood of malignant degeneration. At radiography, chondroblastomas
have a round contour, sharp margins, and cortical scalloping, whereas chondrosarcomas
are large masses with indistinct margins, cortical breakthrough, and soft-tissue
extension. By identifying either a process affecting a cartilage-containing
structure or a cartilaginous matrix within a lesion, the chest radiologist
may be able to narrow the list of differential diagnostic possibilities
substantially.
Review
Review, tutorial
PMID: 9747610, UI: 98418382
