Halo sign (chest)
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The halo sign (HS) in chest imaging is a feature seen on lung window settings (typically HRCT), ground glass opacity surrounding a pulmonary nodule or mass and represents haemorrhage. It is typically seen in angioinvasive aspergillosis.
Pathology
Histopathologically, it represents a focus of pulmonary infarction surrounded by alveolar hemorrhage.
Diagnostic considerations
Other entities that may give a halo sign include:
Infectious disease
- fungi
- septic embolism
- mycobacterial
- rickettsia - rickettsia pneumonia
- Coxiella burnetti - Q fever pneumonia
- viral: herpes simplex virus, varicella zoster virus (chicken pox), cytomegalovirus, myxovirus
Neoplasia
- primary tumours
- adenocarcinoma of lung, adenocarcinoma in situ or minimally invasive (formerly bronchioalveolar carcinoma) - has been described as the most commonly encountered with HS in immunocompetent patients 5
- squamous cell carcinoma of lung
- Kaposi sarcoma
- pulmonary lymphoma
- lung metastases (especially - haemorrhagic pulmonary metastases):
- angiosarcoma
- choriocarcinoma
- osteosarcoma
- melanoma
- metastasis from gastrointestinal adenocarcinoma (<10%)
Non-neoplastic, non-infectious, inflammatory diseases
- Wegener granulomatosis
- eosinophilic lung disease
- pulmonary endometriosis
- organizing pneumonia
- hypersensitivity pneumonitis
- iatorgenic injury
- pulmonary pseudoaneurysm
See also
-<li>rickettsia - <a title="rickettsia pneumonia" href="/articles/rickettsia-pneumonia">rickettsia pneumonia</a>- +<li>rickettsia - <a href="/articles/rickettsia-pneumonia">rickettsia pneumonia</a>
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Image 1 Pathology ( update )
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Image 4 CT (lung window) ( update )
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Case 43: rectal cancer metastasis