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Round pneumonia: imaging findings in a large series of children
Yong-Woo Kim1, Lane F Donnelly
1Department of Radiology, Cincinnati Children's Hospital Medical Center, MLC 503, Cincinnati, OH 45229-3039, USA.
Insights
Round pneumonia in children is often solitary and posteriorly located, typically resolving with treatment. Misdiagnosis of other conditions as round pneumonia is rare in this age group.
Area of Science:
- Pediatric Radiology
- Pulmonology
- Medical Imaging
Background:
- Round pneumonia, a recognized clinical condition, lacks extensive recent case reviews.
- Existing knowledge primarily stems from limited case reports and small series dating back to the 1960s and 1970s.
Purpose of the Study:
- To conduct a comprehensive review of imaging findings in a large cohort of children diagnosed with round pneumonia.
- To update the understanding of round pneumonia characteristics in pediatric patients based on recent data.
Main Methods:
- Retrospective analysis of radiographic and computed tomography (CT) findings in children with round pneumonia from 2000-2006.
- Exclusion of children with pre-existing medical conditions.
- Review of epidemiologic data, imaging features, and follow-up assessments.
Main Results:
- The study included 109 children (mean age 5 years) with round pneumonia.
- Most cases were solitary (98%), had well-defined borders (70%), and were located posteriorly (83%).
- Resolution on follow-up imaging was common (95%), with rare progression to lobar pneumonia (4.6%) or misdiagnosis (2.6%).
Conclusions:
- Round pneumonia is predominantly seen in young children, typically presenting as a solitary, posterior lesion.
- Imaging characteristics and follow-up suggest a generally favorable prognosis.
- Accurate diagnosis is usually achieved, with infrequent misidentification of other pathologies.
Background:
Although round pneumonia is a well-known clinical entity, there have been no large case reviews, with most knowledge based on case reports and small series from the 1960s and 1970s.
Objective:
To review the imaging findings of a large series of children with round pneumonia.
Materials And Methods:
A retrospective review of radiographic and CT findings in all children reported to have round pneumonia at a large children's hospital from 2000 to 2006 was performed. Children with underlying medical conditions were excluded. Epidemiologic characteristics, radiographic and CT findings, and follow-up imaging were reviewed.
Results:
The review identified 109 children (mean age 5 years, range 4 months to 19 years). Round pneumonias tended to be solitary 98% (107/109), have well-defined borders 70% (77/109), and be posteriorly located 83% (91/109), with the following lobar distribution: left lower lobe (36), right lower lobe (33), right upper lobe (28), left upper lobe (7), right middle lobe (4), and lingula (2). Round pneumonia tended to resolve on follow-up imaging (95%, 41/43) as compared to progression to lobar pneumonia (4.6%, 2/43). Three patients (2.6%, 3/112) originally suspected to have round pneumonia were later shown to have other diagnoses: cavitary necrosis in pneumonia (two) or pleural pseudocyst (one).
Conclusion:
Round pneumonia occurs in young children (mean age 5 years), tends to be a solitary lesion, and is most commonly posteriorly located. Misdiagnosis of other pathology as round pneumonia is uncommon.
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