Answer for BIR CoW 02 Aug 2026
APLA Syndrome lung manifestation
Findings
Multiple patchy air space opacities with surrounding GGOs noted in bilateral lung fields, predominantly in bilateral upper lobes. Calcified thrombus noted within left pulmonary artery extending to its lobar branch Multiple calcific foci in right interlobar artery extending into posterobasal and lateral segmental branches of right lower lobe.
FEATURES SUGGESTIVE OF DIFFUSE ALVEOLAR HEMORRHAGE WITH CHRONIC PULMONARY THROMBOEMBOLISM
Discussion
APLA is a systemic autoimmune disease characterized by recurrent thromboembolic events and/or morbidity in pregnancy in the presence of laboratory evidence of antiphospholipid antibodies (aPL), including anticardiolipin antibodies, anti beta 2 glycoprotein 1 antibodies and lupus anticoagulant. Pulmonary manifestations of APLA : Pulmonary hypertension Catastrophic antiphospholipid syndrome and acute respiratory distress syndrome Diffuse alveolar hemorrhage and pulmonary capillaritis Fibrosing alveolitis Postpartum syndrome. Radiological Findings: Diffuse alveolar hemorrhage shows diffuse ground-glass opacities with subpleural sparing consistent with a non- cardiogenic pulmonary edema pattern. Pulmonary thromboembolism : On CTPA – filling defects within pulmonary vasculature with acute pulmonary emboli. On axial plane, this is seen as POLO MINT SIGN. Chronic thromboembolism shows occlusive or non occlusive filling defects in periphery of vessels which forms obtuse angles with vessel wall.
References:
https://www.emjreviews.com/rheumatology/article/antiphospholipid-syndrome-and-the-lungs/
https://pubs.rsna.org/doi/10.1148/rg.240114
Findings
Multiple patchy air space opacities with surrounding GGOs noted in bilateral lung fields, predominantly in bilateral upper lobes. Calcified thrombus noted within left pulmonary artery extending to its lobar branch Multiple calcific foci in right interlobar artery extending into posterobasal and lateral segmental branches of right lower lobe.
FEATURES SUGGESTIVE OF DIFFUSE ALVEOLAR HEMORRHAGE WITH CHRONIC PULMONARY THROMBOEMBOLISM
Discussion
APLA is a systemic autoimmune disease characterized by recurrent thromboembolic events and/or morbidity in pregnancy in the presence of laboratory evidence of antiphospholipid antibodies (aPL), including anticardiolipin antibodies, anti beta 2 glycoprotein 1 antibodies and lupus anticoagulant. Pulmonary manifestations of APLA : Pulmonary hypertension Catastrophic antiphospholipid syndrome and acute respiratory distress syndrome Diffuse alveolar hemorrhage and pulmonary capillaritis Fibrosing alveolitis Postpartum syndrome. Radiological Findings: Diffuse alveolar hemorrhage shows diffuse ground-glass opacities with subpleural sparing consistent with a non- cardiogenic pulmonary edema pattern. Pulmonary thromboembolism : On CTPA – filling defects within pulmonary vasculature with acute pulmonary emboli. On axial plane, this is seen as POLO MINT SIGN. Chronic thromboembolism shows occlusive or non occlusive filling defects in periphery of vessels which forms obtuse angles with vessel wall.
References:
https://www.emjreviews.com/rheumatology/article/antiphospholipid-syndrome-and-the-lungs/
https://pubs.rsna.org/doi/10.1148/rg.240114
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!