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The fourth pattern includes abnormalities that result in decreased lung attenuation or air-filled lesions.
These include:
- Emphysema
-
- Lung cysts (LAM ... , LIP, Langerhans ... #Diagnosis #Radiology ... #Pulmonary #CTChest ... #SignetRing #RadiologyAssistant
Low Attenuation pattern 
1. Lymphangiomyomatosis (LAM): uniform cysts in woman of child-bearing age; no history of
effusion; sometimes pneumothorax ... Centrilobular emphysema ... #Clinical #Radiology ... #HRCT #CTChest ... Comparison #Table #RadiologyAssistant
Paraseptal emphysema is localized near fissures and pleura and is frequently associated with bullae formation (area
to spontaneous pneumothorax ... compression of adjacent lung ... #Clinical #Radiology ... #CTChest #Paraseptal ... #RadiologyAssistant
On the left three different patients with lung cysts.
From left to right: Lymphangiomyomatosis, LIP and Langerhans
patients with lung ... #Clinical #Diagnosis ... #Radiology #CTChest ... Comparison #LAM #LIP ... Histiocytosis #RadiologyAssistant
Differential diagnosis of Langerhans cell histiocytosis.
Nodular LCH:
- Sarcoidosis: perilymphatic distribution.
- Metastases: random distribution.
Cystic LCH:
- LAM: round
Centrilobular emphysema ... central dot. - LIP ... #Clinical #Diagnosis ... #Radiology #CTChest ... Comparison #Table #RadiologyAssistant
There is a hydropneumothorax.
Notice the air-fluid level (blue arrow).
The upper lobe is still attached to the
attached to the chest ... There is a lung ... with a cystic lung ... #Clinical #Radiology ... Lymphangioleiomyomatosis #LAM #RadiologyAssistant
Centrilobular emphysema due to smoking. The periphery of the lung is spared (blue arrows). Centrilobular artery
Centrilobular emphysema ... periphery of the lung ... #Clinical #Radiology ... #CTChest #Centrilobular ... #RadiologyAssistant
Cavities frequently arise within a mass or an area of consolidation as a result of necrosis.
We
can heal and end up ... the surrounding lung ... #Clinical #Diagnosis ... #Radiology #CTChest ... #Comparison #RadiologyAssistant
UIP with honeycombing (left) and chronic HP (right)
Differential diagnosis of Hypersensitivity Pneumonitis.
Subacute stage:
- RB-ILD: seen in
centrilobular emphysema ... throughout the whole lung ... #Clinical #Diagnosis ... #Radiology #CTChest ... Fibrosis #Mimic #ILD #RadiologyAssistant
Notice the honeycombing and the preference of the subpleural and basal lung areas. #Clinical #Radiology #CTChest
subpleural and basal lung ... #Clinical #Radiology ... #CTChest #UIP # ... Pneumonitis #ILD #RadiologyAssistant