Faculty Opinions recommendation of Reversed halo sign in invasive fungal infections: criteria for differentiation from organizing pneumonia.

ResumenEl signo del halo invertido se caracteriza por una opacidad central de vidrio esmerilado rodeado por una consolidación del espacio aéreo más densa en forma de una media luna o un anillo. El signo del halo invertido se ha informado en asociación con un amplia gama de enfermedades pulmonares, incluidas las infecciones fúngicas pulmonares invasivas, neumonía por pneumocystis, tuberculosis, neumonía adquirida en la comunidad, granulomatosis linfomatoide, granulomatosis de Wegener, neumonía lipoidea y sarcoidosis. También se observa en neoplasmas pulmonares e infarto y después de radioterapia y ablación por radiofrecuencia de neoplasias malignas pulmonares. También es conocido como signo de halo en reversa o signo del atolón.AbstractThe reversed halo sign is characterized by a central ground-glass opacity surrounded by denser air–space consolidation in the shape of a crescent or a ring. The reversed halo sign has been reported in association with a wide range of pulmonary diseases, including invasive pulmonary fungal infections, pneumocystis pneumonia, tuberculosis, community-acquired pneumonia, lymphomatoid granulomatosis,Wegener granulomatosis, lipoid pneumonia and sarcoidosis. It is also seen in pulmonary neoplasms and infarction, and following radiation therapy and radiofrequency ablation of pulmonary malignancies. It is also known as a reverse halo sign or atoll sign.

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Re: Reversed halo sign: nodular wall as criterion for differentiation between cryptogenic organizing pneumonia and active granulomatous diseases

Clinical Radiology ◽

10.1016/j.crad.2010.02.015 ◽

2010 ◽

Vol 65 (9) ◽

pp. 770-771 ◽

Cited By ~ 15

Author(s):

E. Marchiori ◽

G. Zanetti ◽

B. Hochhegger ◽

K.L. Irion

Keyword(s):

Organizing Pneumonia ◽

Cryptogenic Organizing Pneumonia ◽

Halo Sign ◽

Reversed Halo Sign ◽

Granulomatous Diseases

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Reversed Halo Sign in Active Pulmonary Tuberculosis: Criteria for Differentiation From Cryptogenic Organizing Pneumonia

American Journal of Roentgenology ◽

10.2214/ajr.11.6543 ◽

2011 ◽

Vol 197 (6) ◽

pp. 1324-1327 ◽

Cited By ~ 26

Author(s):

Edson Marchiori ◽

Gláucia Zanetti ◽

Klaus Loureiro Irion ◽

Luiz Felipe Nobre ◽

Bruno Hochhegger ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Organizing Pneumonia ◽

Cryptogenic Organizing Pneumonia ◽

Active Pulmonary Tuberculosis ◽

Halo Sign ◽

Reversed Halo Sign

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Mistaking Reversed Halo Sign with Cavity in Organizing Pneumonia: A Case Report

Dubai Medical Journal ◽

10.1159/000513428 ◽

2021 ◽

pp. 1-4

Author(s):

Mohammad Badr Almoshantaf ◽

Mukhtar Almosli ◽

Ghanem Aljamali

Keyword(s):

Weight Loss ◽

Gold Standard ◽

Wide Spectrum ◽

Daily Practice ◽

Organizing Pneumonia ◽

Radiological Features ◽

Halo Sign ◽

Lung Condition ◽

Reversed Halo Sign ◽

Radiological Manifestation

Organizing pneumonia (OP) is a rare inflammatory lung condition affecting bronchioles and alveoli. Symptoms may include cough, fever, malaise, fatigue, and weight loss with a wide variety of radiological manifestations. Both the unspecific symptoms and the radiological manifestations wide spectrum can make the diagnosis of OP challenging in daily practice. A pathological biopsy is a gold standard for diagnosis. However, there is usually a delay in making the diagnosis as a result of the time that is taken to decide to perform the biopsy. We present a case of OP in which its radiological manifestation first was mistaken for a cavity instead of the reversed halo sign (atoll sign) due to the similarity in some radiological features.

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Tomographic assessment of thoracic fungal diseases: a pattern and signs approach

Radiologia Brasileira ◽

10.1590/0100-3984.2017.0223 ◽

2018 ◽

Vol 51 (5) ◽

pp. 313-321 ◽

Cited By ~ 4

Author(s):

Pedro Paulo Teixeira e Silva Torres ◽

Marcelo Fouad Rabahi ◽

Maria Auxiliadora Carmo Moreira ◽

Pablo Rydz Pinheiro Santana ◽

Antônio Carlos Portugal Gomes ◽

...

Keyword(s):

Pleural Effusion ◽

Opportunistic Infections ◽

Fungal Infections ◽

Immunological Status ◽

Halo Sign ◽

Clinical Presentations ◽

Computed Tomography Scans ◽

Reversed Halo Sign ◽

Pulmonary Fungal Infections ◽

Considerable Morbidity

Abstract Pulmonary fungal infections, which can be opportunistic or endemic, lead to considerable morbidity and mortality. Such infections have multiple clinical presentations and imaging patterns, overlapping with those of various other diseases, complicating the diagnostic approach. Given the immensity of Brazil, knowledge of the epidemiological context of pulmonary fungal infections in the various regions of the country is paramount when considering their differential diagnoses. In addition, defining the patient immunological status will facilitate the identification of opportunistic infections, such as those occurring in patients with AIDS or febrile neutropenia. Histoplasmosis, coccidioidomycosis, and paracoccidioidomycosis usually affect immunocompetent patients, whereas aspergillosis, candidiasis, cryptococcosis, and pneumocystosis tend to affect those who are immunocompromised. Ground-glass opacities, nodules, consolidations, a miliary pattern, cavitary lesions, the halo sign/reversed halo sign, and bronchiectasis are typical imaging patterns in the lungs and will be described individually, as will less common lesions such as pleural effusion, mediastinal lesions, pleural effusion, and chest wall involvement. Interpreting such tomographic patterns/signs on computed tomography scans together with the patient immunological status and epidemiological context can facilitate the differential diagnosis by narrowing the options.

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