Radiology of the Thorax Flashcards
Spreading to both hemastorases
Mediastinum, from lymphadenopathy
Degenerating ribs
Cancer of the nerves under the ribs
Lung Diseases may affect…
Pulmonary Arteries: vasculitis, pulmonary emboli
Bronchi: Asthma, bronchitis, bronchiectasis
Lung Parenchyma: Pneumonia, lung cancer, emphysema
Common Lung Abnormalities
Pneumonia Lung Cancer- primary or metastases Trauma (not always clear) Pulmonary Emboli Cardiac Failure (CHF) Chronic Diffuse Lung Disease
Important Questions
1) pattern of Lung abnormality
Focal
Multifocal
Diffuse
2) Acute or Chronic (history)
2) Other; eg) cardiomegalyNoule in middle of lung
Calcified Nodule, ‘granuloma’
NZ: TB
Pace Maker means the Heart is..
BIG
Focal abnormality, poorly marginated. Symptoms and potential causes
Cancer or Pneumonia
Productive cough
Crackles of Auscultation
Fever
Leans towards pneumonia
Well defined, Focal adhesion
Patient more likely to have haemoptosis, weight loss»_space;> cancer
LOBAR COLLAPSE
Pneumonia more likely to cause partial or complete lobar collapse.
BUT if there’s a tumor in the lower lobe bronchus then your gonna get obstruction behind it.
Bronchoscopy or CT scan.
Pneumonia vs Cancer
History: symptoms, time course
Exam
CXR appearance
Lobar collapse is due to a
Obstruction
Multifocal (including nodules)
Acute: Infection such as staph or TB
Subacute or Chronic: metastases, sarcoidosis
Staph multifocal disease
Multiple Nodule
IV Drug abuser
TB looks like
- Big cavitating mass
- Can be asymptomatic
- Multiple nodules, mainly in UPPER lobes
- cavitary lesion
- lympadenopathy
- Can also have pleural effusion or mediostina, lymphadenopathy
Strange in terms of symptoms
Diffuse Lung Disease
+200 diffuse lung diseases
- Acute vs Chronic
- Patterns of distribution
Acute diffuse lung disease
FLUID: pulmonary oedema/CHF
PUS: Pneumonia
BlOOD: Good pastures
If asymmetric more likely to be pneumonia
Chronic Diffuse lung diseases
Destruction: Emphysema, malignancy and Fibrotic lung disease >100
Upper Lobes: TB, radiation, eosinophillic pneumonia, sarcoidosis, silicosis
Lower Lobes: UIP (peripheral), asbestosis, lymphangitic metastases
Anywhere: Metastases
Only a few ways the lungs can respond to trauma. In regards to upper lobe diffuse issues
1) Fibrosis or scarring: there are some disease that really like to scar in the upper lobes (less airated, less blood clearance)
Eg; in TB there can be scarring whilst the lungs are healing
Sarcoidosis
Silicosis
UIP/IPF:
Most common chronic diffuse fibrotic lung disease.
Hard to take a breath.
Clinicians hear dry crackles in lower chest.
Peripheral ‘honeycomb’ lung, normal centrally.
Common CT disease with peripheral honeycomb appearance
- Ideopathic*
- Rhematoid Arthritis*
- Progressive systemic sclerosis/scleroderma*
- SLE
- Aspestosis
These lead to UIP
Bronchopulmonary Segment (secondary lobule)
Smallest lung unit that is regularly visible on CXR and CT scans
-unit of lung within interlobular septae, supplied by 3-5 terminal bronchi
Lymphandritic cancer> thickened interlobular septae
