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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The fourth pattern includes abnormalities that result in decreased lung attenuation or air-filled lesions.
These include:
- Emphysema
-
These include: - Emphysema ... on the basis of HRCT ... Radiology #Pulmonary #CTChest ... LowAttenuation #Differential ... #SignetRing #RadiologyAssistant
Low Attenuation pattern 
1. Lymphangiomyomatosis (LAM): uniform cysts in woman of child-bearing age; no history of
Centrilobular emphysema ... #Clinical #Radiology ... #HRCT #CTChest ... Pattern #Comparison #Table ... #RadiologyAssistant
Low Attenuation pattern (2) 
1. Centrilobular emphysema: low attenuation areas without walls. Notice the centrilobular artery
Centrilobular emphysema ... #Clinical #Radiology ... #HRCT #CTChest ... Pattern #Comparison #Table ... #RadiologyAssistant
Upper lung zone preference is seen in:
- Inhaled particles: pneumoconiosis (silica or coal)
- Smoking related diseases
(centrilobular emphysema ... Radiology #Pulmonary #HRCT ... #ChestCT #Differential ... #Table #Distribution ... #Upper #Lower #RadiologyAssistant
High Attenuation pattern (2) 
1. Non specific interstitial pneumonitis (NSIP): ground glass with traction bronchiectasis, no
result of massive fibrosis ... #Clinical #Radiology ... #HRCT #CTChest ... Pattern #Comparison #Table ... #RadiologyAssistant
High Attenuation pattern 
1. Chronic eosinophilic pneumonia with peripheral areas of ground glass opacity.
2. Sarcoid end-stage
end-stage with massive fibrosis ... consolidation #Clinical ... #Radiology #HRCT ... #CTChest #HighAttenuation ... #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
Nodular pattern
1. Hypersensitivity pneumonitis: ill defined centrilobular nodules.
2. Miliary TB: random nodules
3. Sarcoidosis: nodules with perilymphatic
#Clinical #Radiology ... #HRCT #CTChest ... Pattern #Comparison #Table ... #RadiologyAssistant
Chronic hypersensitivity pneumonitis
The key findings in chronic hypersensitivity pneumonitis are:
Mosaic pattern with areas of ground-glass atenuation
Fibrosis and parenchymal ... The HRCT shows a ... #Clinical #Radiology ... #CXR #CTChest # ... #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 ... show very similar HRCT ... #Clinical #Diagnosis ... #Radiology #CTChest