chest and cardiac imaging Flashcards
solitary pulmonary nodule
granuloma-central/diffuse/popcorn/lamellated calcification
neoplasm
hamartoma-30% calcify, 60% show macroscopic fat
multiple pulmonary nodules
metastases (random, lower lobes). Cannonball classically RCC/choriocarcinoma
tb, histoplasmosis, coccidoidomycosis
septic emboli - may sow “feeding vessel sign” also seen with mets
GPA (Wegener) -cANCA
RA
pulmonary mass/nodule with cavitation
Tb Fungal disease SCC Septic emboli GPA, RA
“CAVITY” mneumonic:
Cancer (SCC)
Autoimmune (sarcoid, GPA) also Angioinvasive Aspergillus
Vascular (septic emboli/bland emboli
Infection (staph, Tb)
Trauma (pneumatocoele)
Youth (CPAM, sequestration, bronchogenic cyst)
miliary pulmonary nodules
tb histoplasmosis metastases healed varicella pneumoconioses (these are more correctly perilymphatic and centrilobular)
centrilobular pulmonary nodules
HP RB ILD infectious bronchiolitis -especially consider Tb and MAI (lingula and RML - "lady windermere") endobronchial tumour spread pneumoconioses
cystic lung disease
Emphysema (mimic, these are not actually cysts)
LAM - uniform round cysts
LCH - nodules and irregular cysts, subpleural sparing
PJP
LIP - sjogrens/AIDs, GGO, CL nodules and cysts
I would add:
DIP
Birt-Hogg-Dube: bilateral renal oncocytomas and chromophobe RCCs, cutaneous fibrofolliculomas and lower zone, subpleural, lentiform cysts
lower lobe ILD
UIP pattern ILD - IPF, CTD (RA) -straight edge sign and anterior upper lobe sign are suggestive of CTD, amiodarone, chronic HP
NSIP - collagen vascular disease (SLE, scleroderma), drug induced, idiopathic
Asbestosis
upper lobe ILD
Complicated Silicosis, CWP Complicated Sarcoidosis Tb, CF, ABPA Ankylosing Spondylitis LCH Chronic HSP
Unilateral hyperlucent lung
Inhaled FB and air trapping
PE: Westermark sign (Other PE signs: Fleishner/Hampton hump)
Pneumothorax
Chest wall: mastetomy/Poland
Swyer-James-MacLeod: obliterative bronchiolitis post mycoplasma: small hyperlucent lung with diminished vascularity
Asthma
I confuse:
A. Swyer-James: : obliterative bronchiolitis post mycoplasma: small hyperlucent lung with diminished vascularity
B. Congenital lobar overinflation: enlarged, hyperlucent, oligaemic lung with mass effect in neonate
C. Bronchial atresia: hyperlucent lobe with finger-in-glove mucocoele
Anterior mediastinal mass
lymphoma, germ cell tumour, thymic epithelial neoplasm, thyroid lesion
thymic sepctrum includes hyperplasia (signal drop out), thymoma, invasive thymoma and thymic carcinoma
pericardial cyst, thymic cyst
Middle mediastinal mass
lymphadenopathy
calcified: sarcoid, silicosis, treated lymphoma, Tb, less commonly papillary thyroid, mucinous adenocarcinoma or osteosarcoma mets
vascular abnormality
foregut duplication cyst
hiatal hernia
posterior mediastinal mass
paraganglioma
nerve sheath tumour in adult: sch/NF/MNST
sympathetic ganglion cell tumour in child: ganlgioneurome/ganglioneuroblastoma/neuroblastoma
oesophageal duplication cyst/bronchogenic cyst
neurenteric cyst
lymphoma
extramedllary haematopoiesis
mediastinal haematoma
lateral thoracic meningocoele
chronic air space disease
OP - peripheral migratory GGO/consolidation, atoll/arcade, nodules “reverse batwing
cancer esp. adenocarcinoma
PAP
EP - chronic, UZ, peripheral consolidation “reverse batwing”
Lipoid pneumonia
Peripheral air-space disease
EP - chronic, UZ, peripheral consolidation “reverse batwing”
OP - peripheral migratory GGO/consolidation, atoll/arcade, nodules “reverse batwing
Embolic disease
Contusion
GGO
oedema infection esp atypicals e.g. CMV, PJP ARDS (normal heart size, no effusion) haemorrhage - trauma, vasculitis PAP
Hilar Lymphadenopathy
Hodgkin Lymphoma
Sarcoidosis
Infection
Metastasis
Pneumoconioses
Calcified Pleural Disease
Asbestos exposure
Fibrothorax post empyema, haemothorax
Talc pleurodesis
Bronchiectasis
Post infectious, CF, ABPA, obstructie lesion and primary ciliary dyskinesia
Capt. Kangaroo has Mounier Kuhn:
CF, congenital cystic nronchiectasis (Willams campbell) ABPA Prior infection Tb Kartageners/PCD Mounier Kuhn
and obstructing lesion
Perilymphatic nodules
Sarcoidosis, silicosis, CWP
lymphangitic carcinomatosis
Lymphoproliferative disorder/LIP
Pleural mass
Solitary pulmonary nodule -pedunculated, HPOA, hypoglycaemia
Mesothelioma
Metastasis
Empyema (empyema necessitans: Tb, actinomyces, nocardia)
HIV related lung disease
PJP CD4<200
CMV
LIP (GGO and centrilobular nodules) and Lymphoma
TB/histoplasmosis
Kaposi Sarcoma (nearly all have skin involvement)
Invasive aspergillus - air crescent indicative of healing
Abnormal LV contour/calcification
true aneurysm - wide neck, anterior
false aneurysm (contained rupture) - narrow neck, posterior, surgically managed
pericardial cyst or mass
pericardial calcification: tb, rheumatic fever, uraemia, pericarditis, haemocardium
Cardiac Mass
Thrombus - most common
Mets - most common malignancy: melanoma/leukaemia/lymphoma
Myxoma - LA, most common primary, pedunculated
Rhabdomyoma - TS, children, IV septum
Lipoma/fibroma
Angiosarcoma/pleiomorphic undifferentiated sarcoma/liposarcoma
Delayed myocardial enhancement
Infarct - initially subendocardial myocarditis (mid-wall) sarcoid amyloid neoplasm
Cardiac fat
lipoma (RA)
lipomatous hypertrophy of the IA septum -spares fossa ovalis
arrythmogenic RV dysplasia
Coronary Artery Disease
atheroscleosis: >50% significant
coronary artery aneurysm: iatrogenic, kawasaki
anomalous coronary arteries: pulmonary arterial origin and interarterial course are significant
Dissection: FMD, postpartum, CTD, iatrogenic
Aortic valve disease
stenosis: bicuspid, degenerative
regurgitation: root dilatation (marfan), RhF
Chest Wall Mass
Askin tumour/Ewing sarcoma Metastasis Lipoma Rib tumour: osteochondroma, chondrosarcoma Empyema necessitans elastofiboma dorsi
Enlarged cardiac silhouette
Cardiomegally: cardiomyopathy, valvular disease
Pericardial effusion
Mediastinal mass
Acute aortic syndrome
IMH
PAU
Dissection
