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Chest Radiographic and CT Manifestations of Chronic Granulomatous Disease in Adults

¹ Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.
² Present address: Department of Radiology, New York University School of Medicine, 560 First Ave., IRM 236, New York, NY 10016.
³ Division of Infectious Diseases, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.
⁴ Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.

OBJECTIVE. The purpose of this study was to describe the thoracic radiologic findings of chronic granulomatous disease in adults.

MATERIALS AND METHODS. We retrospectively analyzed the chest radiographic and CT findings in four adults with chronic granulomatous disease during five episodes of lower respiratory tract infection.

RESULTS. Chest radiographic findings included areas of consolidation (60%), diffuse reticulonodular opacities (40%), pleural effusion (20%), and pulmonary artery enlargement (20%). CT findings included areas of consolidation (60%), pulmonary nodules in a random distribution (60%), centrilobular nodules (60%), tree-in-bud opacities (40%), areas of scarring and traction bronchiectasis (100%), emphysematous changes (75%), areas of decreased attenuation and vascularity associated with air trapping on expiratory CT (50%), mediastinal and/or hilar lymphadenopathy (60%), pulmonary artery enlargement (50%), and pleural effusion (20%). Areas of consolidation and nodules were the most prominent findings and at histologic examination were found to be associated with infection or granulomatous inflammation.

CONCLUSION. The pulmonary radiologic findings of chronic granulomatous disease include consolidation, nodules, areas of scarring, traction bronchiectasis, emphysema, air trapping, mediastinal and hilar lymphadenopathy, pulmonary artery enlargement, and pleural effusion.

Keywords: chest imaging • chronic granulomatous disease • primary immunodeficiency disorders • pulmonary imaging • pulmonary infection

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