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The fourth pattern includes abnormalities that result in decreased lung attenuation or air-filled lesions.
These include:
- Emphysema
-
These include: - Emphysema ... #Diagnosis #Radiology ... TractionBronchiectasis #Cysts #Emphysema ... #SignetRing #RadiologyAssistant
Upper lung zone preference is seen in:
- Inhaled particles: pneumoconiosis (silica or coal)
- Smoking related diseases
(centrilobular emphysema ... Pulmonary edema #Diagnosis ... #Upper #Lower #RadiologyAssistant
Differential diagnosis of Langerhans cell histiocytosis.
Nodular LCH:
- Sarcoidosis: perilymphatic distribution.
- Metastases: random distribution.
Cystic LCH:
- LAM: round
Differential diagnosis ... Centrilobular emphysema ... LIP #Clinical #Diagnosis ... Comparison #Table #RadiologyAssistant
Cavities frequently arise within a mass or an area of consolidation as a result of necrosis.
We
the differential diagnosis ... associated pulmonary emphysema ... #Clinical #Diagnosis ... #Cavity #Cyst #Emphysema ... #Comparison #RadiologyAssistant
On the left a chest film of a 19 year old patient with Langerhans cell histiocytosis.
The
challenging differential diagnosis ... centrilobular emphysema ... Emphysema however ... diseases and also in emphysema ... Histiocytosis #Cystic #RadiologyAssistant
Differential diagnosis of Lymphangiomyomatosis:
Langerhans cell histiocytosis: > 90% are smokers, cysts have irregular shapes and the
Differential diagnosis ... Centrilobular emphysema ... #LAM #Cystic #RadiologyAssistant
Lung abnormalities mostly present as areas of increased density, which can be divided into the following
are seen as in emphysema ... #Diagnosis #Pathophys ... Lung #Patterns #RadiologyAssistant
Honeycombing is defined by the presence of small cystic spaces with irregularly thickened walls composed of
from paraseptal emphysema ... #Diagnosis #Radiology ... #Differential #RadiologyAssistant
UIP with honeycombing (left) and chronic HP (right)
Differential diagnosis of Hypersensitivity Pneumonitis.
Subacute stage:
- RB-ILD: seen in
) Differential diagnosis ... centrilobular emphysema ... #Clinical #Diagnosis ... Fibrosis #Mimic #ILD #RadiologyAssistant
Basic Interpretation
A structured approach to interpretation of HRCT involves the following questions:
What is the dominant HR-pattern:
reticular
nodular
high
low attenuation (emphysema ... bronchiectasis) #Diagnosis ... Algorithm #ILD #RadiologyAssistant