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 ... #Cysts #Differential ... #Comparison #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 ... #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
-
cysts (LAM, LIP ... Langerhans cell histiocytosis ... #Diagnosis #Radiology ... LowAttenuation #Differential ... TractionBronchiectasis #Cysts
Cavities frequently arise within a mass or an area of consolidation as a result of necrosis.
We
them from cysts ... the surrounding lung ... #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
On the left another case of Langerhans' cell histiocytosis.
It started as small noduli, which progressed over
Langerhans' cell histiocytosis ... bizarre shaped cysts ... replace normal lung ... #Clinical #Radiology ... #Cystic #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
Differential diagnosis on HRCT
Most of our knowledge about imaging findings in interstitial lung disease comes from
low attenuation (table ... When the cysts have ... Langerhans cell histiocytosis ... #Diagnosis #Radiology ... #RadiologyAssistant
Upper lung zone preference is seen in:
- Inhaled particles: pneumoconiosis (silica or coal)
- Smoking related diseases
Upper lung zone ... Langerhans cell histiocytosis ... edema #Diagnosis #Radiology ... HRCT #ChestCT #Differential ... #Table #Distribution