Interstitial & Alveolar Flashcards
Dr. Griffin
What is this?
an aortic knob
What is an aortic knob? Is it normal?
refers to the prominent, rounded contour where the aortic arch curves.
It represents the portion of the aorta where the ascending aorta transitions into the aortic arch, and it is visible on the left side of the chest in lateral or dorsoventral radiographs
mostly is normal
What is a dorsal invagination of the trachea?
the trachea’s dorsal membrane, the soft tissue that forms the top (dorsal) portion of the trachea, sags or collapses inward
What is this?
dorsal invagination of the trachea
An older cat is coughing and retching. Radiographs show this. What is your primary differential?
asthma
asthma
asthma
This cat who is coughing and retching could also have something else. What could that be?
could be atypical cardiogenic pulmonary edema or congestive heart failure
evaluate heart to see if it is enlarged
What is interstitial unstructured patternA?
hazy lungs
What are radiographic features of interstitial pattern?
increased background opacity of the lung - not as severe as alveolar
can still larger pulmonary vessels, but they look fuzzy
Which pulmonary pattern for both?
left: interstitial: honeycombing, reticulation, & small cystic changes scattered throughout the lung parenchyma
right: normal
Which pulmonary pattern?
interstitial - unstructured
Which pulmonary pattern?
interstitial pattern
Which side (R or L) has a pulmonary pattern? Which one?
right - interstitial pattern
Which pulmonary pattern?
interstitial
Which pulmonary pattern?
interstitial
What are some theoretical interstitial pattern mechanisms?
excess stuff in the interstitial space
- edema
- inflammatory infiltrates
- hemorrhage
- neoplastic infiltrates
- idiopathic fibrosis
What can interstitial patterns be concurrent with?
interstitial and alveolar
What are some causes of interstitial patterns?
cardiogenic pulmonary edema - fluid leaking into interstitium
non-cardiogenic pulmonary edema
hemorrhage
- trauma
- coagulopathy
- leptospirosis
infectious / inflammatory disease
diffuse neoplastic process (lymphoma)
atelectasis
What are lookalikes for interstitial patterns?
dorsal soft tissues are superimposed more on one side
obesity
underexposed image
superimposed soft tissue - skin folds
What are radiographic features of atelectasis?
interstitial or alveolar lung pattern with decreased lung volume
see commonly after surgery or after abdominal ultrasound due to recumbency
What are causes of atelectasis?
expiratory
hypoinflated
sedation
anesthesia
prolonged recumbency in one position
pleural space contents
bronchial obstruction
Explain what happens with the size of the triangle between the cardiac silhouette, causals vena cava, and diaphragm during expiration and inspiration
expiration: smaller triangle
inspiration: bigger triangle
What is this? (ignore arrows)
atelectasis
What is this?
pneumothorax
What is going on with these radiographs?
What is happening here?
heart is shifted to the patient’s left = less room for lung
alveolar pattern
What are some differentials for unstructured interstitial?
What is this pulmonary pattern?
structured interstitial
How do you differentiate nodules and masses?
nodules: soft tissue opaque, usually round - less affected by lung lobe margins at small sizes
masses: soft tissue opaque, can be round or irregularly shaped, ill-defined margins, can have air bronchograms
What are some types of structured interstitial patterns?
nodules or masses: solitary, multiple, diffuse
solide
cavitary - gas and soft tissue
What are some causes of pulmonary nodules/masses?
neoplasia, neoplasia, neoplasia
metastatic neoplasia
granulomas - fungal
solitary nodule/mass
What are 99% the cause of structured interstitial patterns?
neoplasia - metastatic if multiple
granulomas - fungal disease
What pulmonary pattern?
structured interstitial
Miliary nodules are very tiny and are indicative of what? What pulmonary pattern?
metastatic cancer
structured interstitial
What pulmonary pattern?
structured interstitial pattern
T/F: It is very rare to get pulmonary metastasis that’s mineral opaque
TRUE
What are things that mimic pulmonary modules?
pulmonary osteomas/osteomata
end-on vessels
dermal structures
- dermal nodules/masses
- nipples
What is this?
osseous metaplasia
What is this?
pulmonary osteomas
What is this?
pulmonary osteoma
What is this?
end-on vessel
What are end-on vessels?
perfectly round
same size as local pulmonary vessels
more opaque than nodule of same size
What is this?
cutenous nodules / nipples
Nodule or nipple?
nipple
Nodule or nipple?
nodule
What are these?
osteomas
What is this?
nipple
What is this?
end-on vessels
What test do you use to test for pathology associated with bronchial patterns?
bronchialveolar lavage
What is an alveolar pattern?
consolidated lung lobe; no longer able to visualize blood vessels
What’s at least one thing you should see in at least one of in an alveolar pattern?
air bronchogram
lobar sign
border effacement with adjacent soft tissue structures
What is this?
air bronchogram
What is this?
an air bronchogram
What is an air bronchogram?
lucent airway with surrounding soft tissue opacity
What is this?
an airbronchogram - vessels are border effaced
What is happening here?
there is a lobar sign
What is happening here?
lobar sign
What are some causes of an alveolar pattern?
pneumonia aspiration pneumonia
cardiogenic pulmonary edema
non-cardiogenic pulmonary edema
hemorrhage
atelectasis
eosinophilic bronchopneumopathy
neoplasia (when infiltrative)
