Patterns of Lung Disease Flashcards
secondary pulmonary lobule contents
centrilobular artery, central bronchus; pulmonary veins/lymphatics are in the periphery
encased by interlobular septa
1-2.5 cm
consolidation (XR/CT) /ground glass opacity (CT) pathophysiology
filling of alveoli with fluid/incomplete aeration, alveolar wall thickening, partial filling of alveoli
consolidation causes
acute: pneumonia, pulmonary hemorrhage, ARDS, pulmonary edema
chronic: bronchiooloalveolar carcinoma, organizing pneumonia (peripheral rounded consolidations), chronic eosinophilic pneumonia (upper lobe)
pulmonary vessels visible with GGO or consolidation?
GGO: pulmonary vessels visible
ground glass opacity causes
acute: pulmonary edema (dependent), pneumonia (PJP), pulmonary hemorrhage, ARDS
chronic: broncioalveolar carcinoma, organizing pneumonia, chronic eosinophilic pneumonia, idiopathic pneumonia, hypersensitivity pneumonia, alveolar proteinosis
diffuse/central GGO ddx
pulmonary edema, alveolar hemorrhage, PJP, alveolar proteinosis
peripheral GGO/consolidation ddx
organizing pneumonia, chronic eosinophilic pneumonia (upper lobe), atypical/viral pneumonia, pulmonary edema
interlobular septal thickening–smooth DDX
pulmonary edema, pulmonary alveolar proteinosis, pulmonary hemorrhage, atypical pneumonia
interlobular septal thickening – nodular/irregular/assymmetric DDX
lymphangitic carcinomatosis, sarcoidosis
crazy paving
interlobular septal thickening with superimposed ground glass opacities
GGO: alveoli filled with proteinaceous material
interlobular septal thickening: lymphatics take up proteinaceous material
crazy paving DDX
alveolar proteinosis, PJP, organizing pneumonia, bronchioloalveolar carcinoma, lipoid pneumonia, ARDS, pulmonary hemorrhage
centrilobular nodules
opacification of centrilobular bronchiole at center of SPL
never touch pleural surface
infectious ddx for centrilobular nodules
endobronchial spread of TB, bronchopneumonia, atypical pneumonia (mycoplasma)
inflammatory ddx: centrilobular nodules
HSP, hot tub lung, RB-ILD, diffuse panbronchiolitis, silicosis
perilymphatic nodules locations
subpleural, peribronchovascular, septal
perilymphatic nodule DDX
sarcoidosis (upper lobe predominant), pneumoconioses (similar to sarcoid but history of exposure), lymphangitic carcinomatosis
galaxy sign
confluent perilymphatic nodules
randomly distributed nodules DDX
hematogenous spread
hematogenous mets, pulmonary emboli, pulmonary langerhans cell histiocytosis (has cysts, smoking related disease)
miliary pattern nodules DDX
disseminated TB, fungal infection, hematogenous mets
tree in bud nodules DDX
small airway infection
mycobacteria TB, bacterial pneumonia, aspiration pneumonia, airway invasive aspergillus
tree-in-bud physiology
multiple small nodules connected by linear branching; impacted bronchioles
solitary cavitary lesion ddx
primary bronchogenic carcinoma/squamous cell, TB (upper lobe)
thick irregular wall with solid mural component; >15 mm thickness or spiculated usually malignant
multiple cavitary nodules ddx
vascular origin usually
septic emboli, vasculitis, metastases (uterine, SCC)
cystic lung disease DDX
lymphangioleiomyomatosis, emphysema, pulmonary langerhans cell histiocytosis, diffuse cystic bronchiectasis, pneumocystic jiroveci, lymphoid interstitial pneumonia
ddx for single pulmonary cyst
bulla (>1cm), bleb <1cm, pneumatocele
lower lobe fibrotic changes ddx
IPF (basilar honeycombing), end stage asbestosis (pleural plaques), nonspecific interstitial pneumonia (collagen vascular disease/drug reaction, no honeycombing)
upper lobe fibrotic changes ddx
end stage sarcoidosis, chronic hypersensitivity pneumonitis, end stage silicosis
