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Radiographic and High-Resolution CT Findings of Influenza Virus Pneumonia in Patients with Hematologic Malignancies

Anastasia Oikonomou1, Nestor L. Müller1 and Stephen Nantel2

1 Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 W. 12th Ave., Vancouver, BC V5Z 1M9, Canada.
2 Department of Hematology, Vancouver General Hospital, University of British Columbia, Vancouver, BC V5Z 1M9, Canada.



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  		Fig. 1A. —62-year-old woman with multiple myeloma and influenza virus pneumonia. Posteroanterior chest radiograph shows bilateral air-space consolidation involving mainly upper lobes and associated with ill-defined nodular opacities.

 


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  		Fig. 1B. —62-year-old woman with multiple myeloma and influenza virus pneumonia. High-resolution CT scan obtained at level of right middle lobe shows patchy bilateral areas of ground-glass attenuation, mild septal thickening (black arrows), and ill-defined centrilobular nodules (white arrows) in right lower and middle lobes.

 


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  		Fig. 2A. —34-year-old man with history of acute myeloid leukemia who developed influenza virus pneumonia 80 days after receiving allogeneic bone marrow transplant. Centrilobular nodules were predominant finding. Chest radiograph shows patchy air-space consolidation in right middle lung zone associated with ill-defined nodules. Although mild consolidation is evident in retrocardiac region of left lower lobe, it is difficult to see on radiograph.

 


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  		Fig. 2B. —34-year-old man with history of acute myeloid leukemia who developed influenza virus pneumonia 80 days after receiving allogeneic bone marrow transplant. Centrilobular nodules were predominant finding. High-resolution CT scan shows that right lower lobe has focal area of air-space consolidation (long arrow) in which air bronchogram is seen. Also seen are few centrilobular nodules (short arrows). Postoperative changes related to previous right upper lobectomy are also visible.

 


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  		Fig. 2C. —34-year-old man with history of acute myeloid leukemia who developed influenza virus pneumonia 80 days after receiving allogeneic bone marrow transplant. Centrilobular nodules were predominant finding. High-resolution CT scan obtained at subcarinal level shows centrilobular nodules (black solid arrows) and few branching opacities (tree-in-bud pattern) (white curved arrow) in addition to small areas of consolidation (open arrow) and ground-glass attenuation (white solid arrow).

 

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