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 on HRCT
Most of our knowledge about imaging findings in interstitial lung disease comes from
Differential diagnosis ... about imaging findings ... low attenuation (table ... based on the x-ray findings ... #Differential #
The fourth pattern includes abnormalities that result in decreased lung attenuation or air-filled lesions.
These include:
- Emphysema
-
on the basis of HRCT ... findings. ... Radiology #Pulmonary #CTChest ... LowAttenuation #Differential ... #Diagram #Comparison
Nodular pattern
1. Hypersensitivity pneumonitis: ill defined centrilobular nodules.
2. Miliary TB: random nodules
3. Sarcoidosis: nodules with perilymphatic
Nodular pattern ... Clinical #Radiology #HRCT ... #CTChest #Nodular ... #Pattern #Comparison ... #Table #RadiologyAssistant
The idiopathic interstitial pneumonias (IIPs) comprise a heterogenous group of disorders. 
They represent fundamental responses of
listed in the table ... have specific patterns ... on HRCT and histology ... Radiology #Pulmonary #CTChest ... IdiopathicInterstitialPneumonia #ILD
On the left some diseases with a nodular pattern.
1. Hypersensitivity pneumonitis: ill defined centrilobular nodules.
2. Miliary
with a nodular pattern ... Radiology #Pulmonary #CTChest ... #Nodular #Pattern ... 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
interpretation of HRCT ... the dominant HR-pattern ... there additional findings ... #CTChest #Interpretation ... #Algorithm #ILD
Reticular pattern 
1. Lymphangitic carcinomatosis: irregular septal thickening, usually focal or unilateral 50% adenopathy', known carcinoma.
2.
Reticular pattern ... edema: incidental finding ... #CTChest #Reticular ... #Pattern #Comparison ... #Table #RadiologyAssistant
On the left a smoker with RB-ILD with subtle HRCT-findings.
The dominant pattern is ground glass opacification.
Additional
with subtle HRCT-findings ... The dominant pattern ... there is a broad differential ... interpretion of the HRCT ... Clinical #Radiology #CTChest
UIP with honeycombing (left) and chronic HP (right)
Differential diagnosis of Hypersensitivity Pneumonitis.
Subacute stage:
- RB-ILD: seen in
chronic HP (right) Differential ... show very similar HRCT ... findings ... Diagnosis #Radiology #CTChest ... #UIP #Comparison
Septal thickening
Thickening of the lung interstitium by fluid, fibrous tissue, or infiltration by cells results in
cells results in a pattern ... a predominant finding ... diagnosis (Table ... Radiology #Pulmonary #HRCT ... #CTChest #Reticular