2.8 Interstitial Diseases of the Lung Flashcards
Explain the difference between interstitial diseases and consolidation on a CXR.
Interstitial diseases show filling of the interstitial spaces, whereas consolidation reflects filling of the alveolar spaces.
List the main features of interstitial disease on a CXR.
What are the 3 major patterns of interstitial disease on a CXR?
What are the 2 subsets of reticular disease found on a CXR?
The coarse reticular pattern is a little more irregular and denser than a fine reticular pattern.
List 4 major causes of a fine reticular disease pattern found on CXR.
Describe the CXR features of fine reticular pattern secondary to interstitial oedema.
Interstitial oedema - fluid in the interstitial spaces.
Note the fine prominence of linear opacities in the lungs and the lack of focal consolidation.
Describe the CXR features of fine reticular pattern secondary to infection.
Similar fine reticular pattern to interstitial oedema, note the prominence of the hilum bilaterally.
Usually you need to depend on clincal features to determine the exact cause of the fine reticular pattern; it can be difficult to distinguish radiographically between the related causes.
Describe the CT features of fine reticular pattern secondary to lympangitic spread of a cancer.
What types of cancers are most apt to cause this type of pattern?
Note the reticular prominence of in the R lung compared to the L lung which is clear.
This is actually a mixed reticulo-nodular pattern, as you can see some nodules.
Most common cancers to cause this type of pattern are: breast, lung, pancreas, stomach.
Describe the CT and CXR fine reticular markings and findings secondary to idiopathic pneumonia.
Idiopathic pneumonia is a syndrome where pneumonia-like symptoms can occur, but without obvious infective source.
The most common form is chronic interstitial pneumonia. Its end stage is pulmonary fibrosis.
Note the persistence of the sharp costophrenic angle in the CXR.
What causes a coarse reticular pattern on CXR?
What are the key features?
Pulmonary fibrosis.
Also called ‘honeycomb’ lung due to presence of coarse reticular markings with intervening cystic spaces.
Multiple causes including idiopathic interstitial pneumonia, sarcoid, collagen vascular disease, drug reactions, idiopathic.
Characterised by:
- Progressive volume loss
- Traction bronchiectasis
- End-stage lung disease
What causes interstitial nodules?
Describe the lung nodules caused by tuberculosis.
Describe the nodules caused by reactivation of tuberculosis.
Describe the reticulonodular pattern created by sarcoid.
What are the stages of sarcoid?
