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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Nodular pattern
1. Hypersensitivity pneumonitis: ill defined centrilobular nodules.
2. Miliary TB: random nodules
3. Sarcoidosis: nodules with perilymphatic
pneumonitis: ill defined centrilobular ... Hypersensitivity pneumonitis: centrilobular ... #Clinical #Radiology ... #HRCT #CTChest ... Comparison #Table #RadiologyAssistant
Low Attenuation pattern (2) 
1. Centrilobular emphysema: low attenuation areas without walls. Notice the centrilobular artery
Centrilobular emphysema ... histiocytosis (LCH ... #Clinical #Radiology ... #HRCT #CTChest ... Comparison #Table #RadiologyAssistant
Low Attenuation pattern 
1. Lymphangiomyomatosis (LAM): uniform cysts in woman of child-bearing age; no history of
LCH: multiple round ... Centrilobular emphysema ... #Clinical #Radiology ... #HRCT #CTChest ... Comparison #Table #RadiologyAssistant
Differential diagnosis of Langerhans cell histiocytosis.
Nodular LCH:
- Sarcoidosis: perilymphatic distribution.
- Metastases: random distribution.
Cystic LCH:
- LAM: round
Nodular LCH: - Sarcoidosis ... Cystic LCH: - LAM ... ring sign'. - Centrilobular ... #CTChest #Cystic ... Comparison #Table #RadiologyAssistant
Algorithm for nodular pattern
The algorithm to distinguish perilymphatic, random and centrilobular nodules is the following:
- Look
perilymphatic, random and centrilobular ... #Diagnosis #Radiology ... #Pulmonary #HRCT ... #CTChest #NodularPattern ... Differential #Algorithm #RadiologyAssistant
HRCT findings in Langerhans cell histiocytosis:
Early stage:
- Small irregular or stellate nodules in centrilobular location.
Late stage
HRCT findings in ... in centrilobular ... #Clinical #Radiology ... #CTChest #LCH # ... Histiocytosis #RadiologyAssistant
Chronic hypersensitivity pneumonitis
The key findings in chronic hypersensitivity pneumonitis are:
Mosaic pattern with areas of ground-glass atenuation
The HRCT shows a ... and secondry nodules ... #Clinical #Radiology ... #CXR #CTChest # ... #Fibrosis #RadiologyAssistant
Basic Interpretation
A structured approach to interpretation of HRCT involves the following questions:
What is the dominant HR-pattern:
reticular
nodular
high
interpretation of HRCT ... HR-pattern: reticular nodular ... secondary lobule (centrilobular ... #CTChest #Interpretation ... Algorithm #ILD #RadiologyAssistant
UIP with honeycombing (left) and chronic HP (right)
Differential diagnosis of Hypersensitivity Pneumonitis.
Subacute stage:
- RB-ILD: seen in
associated with centrilobular ... show very similar HRCT ... Clinical #Diagnosis #Radiology ... #CTChest #UIP # ... Fibrosis #Mimic #ILD #RadiologyAssistant
On the left a patient with ground glass pattern in a mosaic distribution.
Some lobules are involved
presents with centrilobular ... are confluent, HRCT ... #Clinical #Radiology ... #CTChest #GGO # ... HypersenstitivityPneumonitis #RadiologyAssistant