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
Langerhans cell histiocytosis ... : round cysts, evenly ... #Radiology #CTChest ... #Cystic #Cysts ... #Table #RadiologyAssistant
On the left three different patients with lung cysts.
From left to right: Lymphangiomyomatosis, LIP and Langerhans
patients with lung cysts ... #Clinical #Diagnosis ... #Radiology #CTChest ... #LAM #LIP #Histiocytosis ... #RadiologyAssistant
Low Attenuation pattern (2) 
1. Centrilobular emphysema: low attenuation areas without walls. Notice the centrilobular artery
Langerhans cell histiocytosis ... multiple thick walled cysts ... (LAM): regular cysts ... #Clinical #Radiology ... #RadiologyAssistant
The fourth pattern includes abnormalities that result in decreased lung attenuation or air-filled lesions.
These include:
- Emphysema
-
Emphysema - Lung cysts ... cell histiocytosis ... #Diagnosis #Radiology ... LowAttenuation #Differential ... TractionBronchiectasis #Cysts
Upper lung zone preference is seen in:
- Inhaled particles: pneumoconiosis (silica or coal)
- Smoking related diseases
bronchiolitis (RB-ILD ... Langerhans cell histiocytosis ... is seen in: - UIP ... edema #Diagnosis #Radiology ... #Table #Distribution
Cavities frequently arise within a mass or an area of consolidation as a result of necrosis.
We
them from cysts ... Cysts occur without ... #Clinical #Diagnosis ... #Radiology #CTChest ... #Cavity #Cyst #
Low Attenuation pattern 
1. Lymphangiomyomatosis (LAM): uniform cysts in woman of child-bearing age; no history of
(LAM): uniform cysts ... bizarre shaped cysts ... #Clinical #Radiology ... Pattern #Comparison #Table ... #RadiologyAssistant
Nodular pattern(2)
1. Sarcoidosis: nodules with perilymphatic distribution, along fissures, adenopathy.
2. TB: Tree-in-bud appearance in a patient
Langerhans cell histiocytosis ... before the typical cysts ... #Clinical #Radiology ... Pattern #Comparison #Table ... #RadiologyAssistant
On the left some diseases with a nodular pattern.
1. Hypersensitivity pneumonitis: ill defined centrilobular nodules.
2. Miliary
before the typical cysts ... #Clinical #Diagnosis ... #Radiology #Pulmonary ... #Comparison #Table ... #RadiologyAssistant
HRCT findings in Langerhans cell histiocytosis:
Early stage:
- Small irregular or stellate nodules in centrilobular location.
Late stage
Langerhans cell histiocytosis ... airspaces Cysts ... There are no cysts ... #Clinical #Radiology ... #RadiologyAssistant