Nodular lung patterns (structured)

Question 1

What is the definition of an interstitial pattern:

Answer 1

One or more abnormal, discrete opacities in the pulmonary interstitim.

Question 2

DDX for interstitial lung patters? (Most common–then others)

Answer 2

_Neoplasia (_bronchogenic carcinoma -dogs –adenocarcinoma cats- mets to one or more digits) and mycotic infection (hematogenous pneumonia) are the most common

Secondary or nets neoplasia

Allergic lung dz (feline asthma, eosinophilic pneumonia)

Granuloatous pneumonia (esoinophilic, lymphoid)

Infarcts (thromboeboli- heartworm (most common), recent sx, prolonged immobilization)

Heart dz (ardiomyopathy, valvular regutgitations, endocarditis)

Disseminated intravascular coagulation (DIC)

Metabolic dz (renal, hyperadrenocrticism, DM, hyperlipidemia)

Inflammation/infection (pancreatitis, pneumonia, pyothorax, sepsis, inflammatory joint dz)

immunocomrpomise/immune mediated hemolytic anemia

Aspiration

Question 3

DDX for smooth-boareder, well defined nodules?`

Answer 3

Neoplasia (primary or mets)

Abscess

Granuloma

Fluid-containing bulla

Question 4

DDX for nodules with indstinct borders?

Answer 4

Inflammation

Hemorrhage

Edema

Actively growing nodule

Increased opacity in adjacent lung

Question 5

DDX for Numerous nodules scattered throughout lungs (snow-storm pattern)?

Answer 5

Metastatic neoplasia

Infection (especially mycotic)

Pulmonary lymphoma

Eosinophilic pneumonia

Question 6

Pseudo-nodules are discrete soft tissue or ______ opacity that mimic pulmonary nodules.

Answer 6

mineral

Heterotopic bone formation (pulmonary osteomas)

Figure 7. Hematoxylin and eosin, original magnification ×100, ×200, ×40. Histopathology of pulmonary ossification. A branching fragment of bone containing marrow protruding into alveolar spaces (arrows). Note the anthracosis (dark brown carbon dusts) of the interstitium (arrowheads).

Question 7

Neoplastic pulmonary nodules ______ mineralize. If a nodule is more opaque than nearby vessels of same size, it represents _____ minrealization or end-on visulization of a _____.

Answer 7

rarely

focal

vessel

Question 8

Interstitial and alveolar patterns differ only in degree of _____. Alveolar patterns are the ONLY lung pattern that can produce ____ _____ opacity in lungs and COMPLETLY obscure pulmonary soft tissue structures.

Answer 8

opacity

soft tissue

Question 9

Nodules are typically present as solid or nearly solid soft tissue structures, ______ from surrounding lung parenchya. It may be homogenous or heterogenous, be mineralize or cavitated (cavitated nodules may fill with gas or fluid). Gas (air) in a nodule may rsult from communication with an ______ or ____ _____.

Answer 9

distinct

airway or central necrosis