Ultrasonic humidifier lung with a reversed halo sign: A case report

Tsukasa Hasegawa, MD, PhD; Kai Ryu, MD, PhD; Taiki Fukuda, MD, PhD; Yuko Mizobuchi, MD; Lynn Yoshimatsu, MD; Ryo Sato, MD; Makiko Takatsuka, MD; Kyota Shinfuku, MD; Masami Yamada, MD, PhD; Yumie Yamanaka, MD, PhD; Yusuke Hosaka, MD, PhD; Aya Seki, MD; Naoki Takasaka, MD, PhD; Takeo Ishikawa, MD; Jun Araya, MD, PhD

Radiology Case Reports (Jun 2024)

Ultrasonic humidifier lung with a reversed halo sign: A case report

Tsukasa Hasegawa, MD, PhD,
Kai Ryu, MD, PhD,
Taiki Fukuda, MD, PhD,
Yuko Mizobuchi, MD,
Lynn Yoshimatsu, MD,
Ryo Sato, MD,
Makiko Takatsuka, MD,
Kyota Shinfuku, MD,
Masami Yamada, MD, PhD,
Yumie Yamanaka, MD, PhD,
Yusuke Hosaka, MD, PhD,
Aya Seki, MD,
Naoki Takasaka, MD, PhD,
Takeo Ishikawa, MD,
Jun Araya, MD, PhD

Affiliations

Tsukasa Hasegawa, MD, PhD: Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae-shi, Tokyo, 201-8601, Japan
Kai Ryu, MD, PhD: Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae-shi, Tokyo, 201-8601, Japan; Corresponding author.
Taiki Fukuda, MD, PhD: Department of Radiology, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae-shi, Tokyo, 201-8601, Japan
Yuko Mizobuchi, MD: Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae-shi, Tokyo, 201-8601, Japan
Lynn Yoshimatsu, MD: Department of Radiology, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae-shi, Tokyo, 201-8601, Japan
Ryo Sato, MD: Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae-shi, Tokyo, 201-8601, Japan
Makiko Takatsuka, MD: Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae-shi, Tokyo, 201-8601, Japan
Kyota Shinfuku, MD: Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae-shi, Tokyo, 201-8601, Japan
Masami Yamada, MD, PhD: Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae-shi, Tokyo, 201-8601, Japan
Yumie Yamanaka, MD, PhD: Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae-shi, Tokyo, 201-8601, Japan
Yusuke Hosaka, MD, PhD: Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae-shi, Tokyo, 201-8601, Japan
Aya Seki, MD: Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae-shi, Tokyo, 201-8601, Japan
Naoki Takasaka, MD, PhD: Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae-shi, Tokyo, 201-8601, Japan
Takeo Ishikawa, MD: Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae-shi, Tokyo, 201-8601, Japan
Jun Araya, MD, PhD: Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan

Journal volume & issue: Vol. 19, no. 6
pp. 2520 – 2524

Abstract

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The reversed halo sign was initially reported as a representative computed tomography scan finding of cryptogenic organizing pneumonia. Since then, however, it has been reported in various diseases and is now considered a nonspecific finding. However, there are no cases of humidifier lung with the reversed halo sign. An 82-year-old Japanese male patient presented with moving difficulties 48 days after starting darolutamide treatment for prostate cancer. He was admitted to the hospital due to acute pneumonia, which presented as bilateral extensive nonsegmental ground-glass opacities in the peripheral regions and extensive areas of ground-glass opacity with a circumferential halo of consolidation, with the reversed halo sign on computed tomography scan. After darolutamide discontinuation with the concomitant administration of antibiotics, the patient's pneumonia improved, and he was discharged from the hospital. However, within a few days, he was again admitted to the hospital due to pneumonia. He was found to have been using an ultrasonic humidifier at home and was then diagnosed with humidifier lung based on the bronchoscopy and provocative testing findings. Hence, ultrasonic humidifier lung should be considered as a differential diagnosis in patients presenting with the reversed halo sign, and a detailed medical history must be taken.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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