Diffuse and focal pulmonary diseases Flashcards
Different chest radiographs
PA, standard
AP
Friehmann-Dahl view.
When is an AP CXR done
basically just when the patient is confined to the bed.
Mediastinum and heart are bigger than normal,
Diaphragm is higher, due to abdominal compression.
How do you know there was sufficient inspiration on a Chest X Ray
The 9th and 10th ribs are visible.
HypERLEUCENCIES
Increased transparency
Emphysema
PTX
Hypoleucencies
Decreased transparency
Diffuse: Pulmonary edema Atelectasia Lobar pneumonia - over a single lobe Bronchopneumonia - patchy infiltrate spread across multiple lobes. Fibrosis/Interstitial diseases
Focal: Neoplasia Aspiration Abscesses TB granulomas Miliary (millet sized lesions) in Milliary TB. Sarcoidosis. pneumoconiosis.
Bundle shaped stripes or striped shadows on a CXR
Striped shadows
Form when connective tissue accumulates around bronchial lymphatic vessels.
Associated with tuberculosis, early and resolving stages on pneumonia.
Radiology of interstitial lung diseases
Linear and reticulonodular consolidations
Upper lung consolidations
Lower lung consolidations
Upper: PAGES
Pneumoconioses, Allergic alveolitis or Ankylosisng Spondylitis, Granulomas, Eosinophilic granulomas, Sarcoidosis
Lower: CIAS
Connective tissue disease, Idiopathic pulmonary fibrosis, Asbestosis, Scleroderma.
Nodular lung consolidations
solitary
multiple
Annular shadows
Solitary nodules TB, Broncial carcinoma, Hamartomas Abscesses Apergillomas Adenoma Infaction
Multiple: Miliary TB Sarcoidosis Silicosis Metastases Wegeners granulomatosis Lymphoma
Anular/Ring shaped
Abscesses,
Emphesematous Bulla
Bronchietasia
Lung calcifications
Tuberculosis calcified granuloma Hamartoma Carcinoid Metastasis. Silicosis
What is an air bronchogram
Air bronchogram refers to the phenomenon of air-filled bronchi (dark) being made visible by the opacification of surrounding alveoli (grey/white). It is almost always caused by a pathologic airspace/alveolar process, in which something other than air fills the alveoli. Air bronchograms will not be visible if the bronchi themselves are opacified (e.g. by fluid) and thus indicate patent proximal airways.
Lung cancer typical locations
Central/hilar
- Squamous cell carcinoma, strong smoking association.
or
- Small cell carcinoma, also smoking associated.
Bronchial Adenocarcinoma - more peripheral, bronchial
Multiple - metastases.
Common primary tumors that metastasize to the lung
1) breast
2) colorectal
3) renal cell carcinoma
4) uterus
5) squamous cell carcinomas of the head and neck.
Pulmonary hypertension sing on CXR
dilated pulmonary arteries at the hilum, constricted vessels at the periphery.
lung edema:
patchy consolidation
Kerley B lines
Hilar thickening can indicate
Pulmonary hypertension
Central neoplasm
Lymphadenopathy, lymphoma or infection
