CT scans of interstitial lung dx

Question 1

Young person with reticulonodular opacities

most commonon XR: 75-90% with

middle and upper zone distribution

Answer 1

sarcoidosis -see areas of fibrosis interspersed with areas of inflammation and see adneopathy and granulomas.

Question 2

see cough, fever, dhyspnea and malaise and myalgias. Sometimes mistaken for CAP and given abx. Symptoms are generally <2 months

Answer 2

cryptogenic organizing pneumonia or COP.

Question 3

daily productive cough and thick sputum. Name the imaging abnormality

Answer 3

bronchiectasis. It’s a result of inflammation or result of scarring of parenchyma. The location of bronchiectasis will explain the etiology
- ABPA will have central bronchiectasis

Question 4

Male pt in 50’s with progressive dyspnea >6 months duration, exertional hypoxemia, dry crackles, and digital clubbing.

Answer 4

See IPF with honey combing, cystic changes, traction bronchiectasis (at bases and subpleural areas)

May not need pulm biopsy if CT scan is characteristic. If question of diagnosis can get pulm biopsy and will see usual interstitial pneumonia on biopsy.

Question 5

usual interstitial pneumonia

Answer 5

Also known as IPF or idiopathic pulmonary fibrosis

Question 6

hypoxemia, dyspnea, petechial rash and confusion.

Long bone fracture

Answer 6

fat embolism - see nonspecific ground glass opacities

Question 7

pt has subacute cough, dyspnea with exertion and symptoms disappear when he’s on vacation. Has a bird at home. what is the CT showing?

Answer 7

hypersensitivity pneumonitis