2. Patterns of Lung Disease Flashcards
The loss of the normal
radiographic contour
Silhouette Sign
If you cannot see the spine through the heart relative to the PA view, the image is
underpenetrated (too light)
consolidation of the LUL (apical posterior segment disease) obliterates the
aortic knob
Lingula consolidation (inferior segment disease) obliterates the
left heart border
An infiltrate (LLL disease) obscures the
descending thoracic aorta
If the consolidation is behind the heart its in the
left lower lobe
will cause a silhouette sign of the upper right
heart border and the right tracheal lung interface
RUL consolidation
will obliterate the left atrium, the aortic knob, and the anterior and middle mediastinum
LUL consolidation
When bronchi are surrounded by diseased fluid filled alveoli, the dense water density of the fluid surrounding the bronchi result in the
air bronchogram sign
indicates that a pulmonary lesion is present
Air bronchogram sign
Sometimes air bronchograms seen through the cardiac shadow is the most definitive sign of
LLL
consolidation
Air filled bronchi that are very crowded together
indicate
nonobstructive
atelectasis
Channels running between two adjacent alveoli across the
alveolar wall
Pores of Kohn & Canals of Lambert
Small apertures which
occur in the alveolar wall
Alveolar Pores (Pores of Kohn)
Permit the spread of bacteria and exudate to
adjacent alveoli
Alveolar Pores (Pores of Kohn)
Openings in the walls of terminal bronchioles or
respiratory bronchioles, which communicate
with alveoli
Canals of Lambert
Provide an alternative route for entry or escape of air and probably play an important role in lung fibrosis
Canals of Lambert
Provide an avenue through which macrophages
can pass from the alveolus to respiratory and
terminal bronchioles
Canals of Lambert
may produce bloody or rust-colored sputum
Pneumococci
may produce sputum
resembling currant jelly due to necrosis, inflammation,
and hemorrhage
Klebsiella and type 3 Pneumococci
results in an aggressive
necrotizing lobar pneumonia
Klebsiella (aka Friedlander) pneumonia
CD4 counts below 200/mm3, small pneumatocoeles, sub pleural blebs, and a fine reticular interstitial pulmonary pattern
Pneumocystis (carinii) jiroveci pneumonia
- Areas of normal lung
- Areas of inflammatio
- Areas of end-stage, scarred, and non-functioning cystic lung with the appearance of a honeycomb.
Usual Interstitial Pneumonia (UIP)
are thin-walled, air-filled cysts that develop within the lung parenchyma
Pulmonary pneumatoceles
Most often, they occur as a sequela to acute pneumonia, commonly caused by Staph aureus
Pulmonary pneumatoceles
opportunistic infection is now most commonly
associated with advanced human immunodeficiency
virus (HIV) infection
Pneumocystis (carinii) jiroveci pneumonia
Bronchopneumonia (lobular pneumonia)
Staphylococcal infection
begins in airways and spreads to peribronchial alveoli and may look like an alveolar pneumonia
Bronchopneumonia (lobular pneumonia)
loss of air space and its replacement with fluid is
called
consolidation
multiple foci of isolated, acute consolidation, affecting
one or more pulmonary lobes
Bronchopneumonia (lobular pneumonia)
an infection in the lungs
caused by bacteria called Streptococcus pneumoniae
Pneumococcal pneumonia
most commonly affected lobes of the lung in Pneumococcal pneumonia?
lower lobe and RML
- pleural effusion from involvement of pleura
- diaphragmatic splinting and elevation
- air bronchograms
Pneumococcal Pneumonia
complication of debilitating disease densities of varying sizes that are poorly defined,
small and mottled
Bronchopneumonia
poorly defined, irregular areas of increased radiodensity in the right lower and middle lobes most commonly
Aspiration Pneumonia
confluent alveolar pneumonia in elderly and debilitated with sudden onset and may be fatal in few days
Klebsiella aka Friedlander’s Pneumonia
initially looks like bronchopneumonia with patchy areas usually upper lobes with pulmonary cavitation
Klebsiella aka Friedlander’s Pneumonia
An acute respiratory disease marked by high fever and coughing; caused by mycoplasma;
Primary Atypical Pneumonia (walking pneumonia)
streaky densities extending from hilum along vascular markings and scattered alveolar patchy densities
peribronchial type of Primary Atypical Pneumonia
poorly defined scattered radiopacities
Bronchopneumonic type of Primary Atypical Pneumonia
may present
in a perihilar location and look like pulmonary edema
viral pneumonia
Frequently bilateral and associated with pleural effusion
viral pneumonia
small, widespread, poorly defined nodules
diffusely scattered throughout lungs
Miliary Pattern
primary TB may spread to the lung via
blood
Cavitation of an acute suppurative pulmonary
infectious process
Lung Abscess
downward displacement of interlobar fissure with increased radiopacity of lobe and blurring of right heart border
Right Middle Lobe Syndrome
Most frequently, the lung abscess arises as a complication of
aspiration pneumonia
patients with aspiration pneumonia commonly have
periodontal disease
collection of air in a
crescentic shape that
separates the wall of a
cavity from an inner mass.
air crescent sign
characteristic of Aspergillus
colonization of preexisting
cavities, and other lesions.
air crescent sign
extravasation of
fluid from the pulmonary vasculature into the interstitium and alveoli
Pulmonary edema
bronchi may dilate
Bronchiectasis
a chronic, destructive,
infective process of bronchi and bronchioles
that results in loss of structural integrity and
permanent abnormal dilation of airways
Bronchiectasis
seen in advanced asthma
hyperinflation
Hyperinflation of the lungs resulting in a radiographic finding of increased radiolucency (air trapping) is the primary change seen in
COPD
abnormal enlargement of the air spaces
Pulmonary Emphysema
associated with emphysema due to liver disease
Alpha 1 Antitrypsin Deficiency
the minimum
expansion to rule out COPD should be
2 inches
large air sac formed by massive alveolar wall breakdown
Bulla
Altered size and shape of the thorax due to formation of a kyphosis
Senescent or Postural Emphysema
deflation of the normal lung with persistent
inflation of obstructed lung
Acute Obstructive Emphysema
most common cause for centrilobular emphysema is
smoking
- segmental or lobar air space consolidation
- ipsilateral hilar and mediastinal lymphadenopathy
- pleural effusion
primary pulmonary TB
a nodule in TB may become calcified or
ossified, resulting in a calcified granuloma called a
Ghon
Lesion
rounded discrete nodules that are
known to harbor bacilli
Tuberculomas
Hilar lymph node calcification
complemented by Ghon lesion
Ranke Complex
