In this first edition of Pearls and Pitfalls in Thoracic Imaging: Variants and Other Difficult Diagnoses , Dr Hartman and colleagues clearly state their intentions for this book in the preface: to provide a thoracic computed tomographic reference similar to Keats’ Atlas of Roentgen Variants . On the surface, this book certainly doesn’t look like Keats—this is a svelte 224 pages versus 1300-plus pages—but this book manages to pack a lot of extremely useful information and beautiful images into a small form factor.
This volume contains 86 cases divided into 12 chapters: airways, lung parenchyma, mediastinum, esophagus, aorta, vascular, pericardium, pleura, diaphragm, lymphatics, positron emission tomography/computed tomography, and artifacts. The organization makes it easily navigable when you see an unfamiliar finding. See some strange calcification in the lungs? Refer to the “Lung Parenchyma” section to see nice examples of alveolar microlithiasis and metastatic pulmonary calcification to see if either fits your case. Alternatively, you can read this book cover to cover and pick up clinical pearls or see examples of unusual diagnoses you have never encountered.
Each chapter contains an appropriate assortment of cases ranging from uncommon (eg, lymphangioleiomyomatosis) to very rare (eg, Williams-Campbell syndrome). The text of each case is divided into five sections: “Imaging Description,” “Importance,” “Typical Clinical Scenario,” “Differential Diagnosis,” and a “Teaching Point” summary box. Discussions are appropriately concise, and the “Importance” and “Typical Clinical Scenario” sections are very good at putting the finding in perspective and suggesting what needs to be done next.
The “Lung Parenchyma” section is the lengthiest (appropriately so), but it was nice to see an entire section devoted to the esophagus, a region of the chest with which many thoracic radiologists have less experience. One of the most well done cases is on pericardial recesses (hopefully this will cut down on the number of referrals we see for an enlarged right inferior pulmonary vein recess being misinterpreted as a mass or lymph node).
The images are large, high quality, and almost all from recent multislice computed tomographic scanners (no fuzzy, 1-cm slice thickness images from the mid-1990s with imperceptible findings in this book!), and radiographs, nuclear medicine studies, and fluoroscopic studies provide nice correlates on many cases. Not only is this book is a worthwhile addition to the library of any cardiothoracic fellow or attending physician, but it is a useful quick reference for any reading room where thoracic computed tomographic images are routinely interpreted. Medical students and residents looking for books on thoracic imaging fundamentals, however, should look elsewhere.
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