Dr. Gerald Diaz @GeraldMD
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Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief πŸ‡΅πŸ‡­ πŸ‡ΊπŸ‡Έ - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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Differential diagnosis of Langerhans cell histiocytosis.
Nodular LCH:
- Sarcoidosis: perilymphatic distribution.
- Metastases: random distribution.
Cystic LCH:
- LAM: round
Centrilobular emphysema ... central dot. - LIP #Clinical ... #CTChest #Cystic ... #Cysts #Differential ... #Comparison #Table
Low Attenuation pattern 
1. Lymphangiomyomatosis (LAM): uniform cysts in woman of child-bearing age; no history of
(LAM): uniform cysts ... Centrilobular emphysema ... #Clinical #Radiology ... #HRCT #CTChest ... #Pattern #Comparison
Low Attenuation pattern (2) 
1. Centrilobular emphysema: low attenuation areas without walls. Notice the centrilobular artery
Centrilobular emphysema ... (LAM): regular cysts ... #Clinical #Radiology ... #HRCT #CTChest ... #Pattern #Comparison
The fourth pattern includes abnormalities that result in decreased lung attenuation or air-filled lesions.
These include:
- Emphysema
-
- Lung cysts (LAM ... #Diagnosis #Radiology ... #Pulmonary #CTChest ... LowAttenuation #Differential ... #Diagram #Comparison
Cavities frequently arise within a mass or an area of consolidation as a result of necrosis.
We
In the differential ... To differentiate ... #Clinical #Diagnosis ... #Radiology #CTChest ... Emphysema #Comparison
On the left a chest film of a 19 year old patient with Langerhans cell histiocytosis.
The
caused by multiple cysts ... most challenging differential ... #Clinical #Radiology ... #CXR #CTChest # ... Histiocytosis #Cystic
Differential diagnosis of Lymphangiomyomatosis:
Langerhans cell histiocytosis: > 90% are smokers, cysts have irregular shapes and the
Differential diagnosis ... 90% are smokers, cysts ... Centrilobular emphysema ... #Clinical #Radiology ... #CTChest #Lymphangiomyomatosis
On the left some diseases with a nodular pattern.
1. Hypersensitivity pneumonitis: ill defined centrilobular nodules.
2. Miliary
before the typical cysts ... #Clinical #Diagnosis ... #CTChest #Nodular ... NodularPattern #Differential ... #Comparison #Table
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 ... , cystic) Where ... Pulmonary #HRCT #CTChest ... Interpretation #Algorithm ... #ILD #RadiologyAssistant
UIP with honeycombing (left) and chronic HP (right)
Differential diagnosis of Hypersensitivity Pneumonitis.
Subacute stage:
- RB-ILD: seen in
chronic HP (right) Differential ... centrilobular emphysema ... #Clinical #Diagnosis ... #Radiology #CTChest ... #UIP #Comparison