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
low attenuation (table ... The cystic pattern ... Langerhans cell histiocytosis ... #Diagnosis #Radiology ... RadiologyAssistant
Low Attenuation pattern (2) 
1. Centrilobular emphysema: low attenuation areas without walls. Notice the centrilobular artery
Low Attenuation pattern ... Langerhans cell histiocytosis ... #Clinical #Radiology ... #Pattern #Comparison ... #Table #RadiologyAssistant
Differential diagnosis of Langerhans cell histiocytosis.
Nodular LCH:
- Sarcoidosis: perilymphatic distribution.
- Metastases: random distribution.
Cystic LCH:
- LAM: round
Langerhans cell histiocytosis ... Clinical #Diagnosis #Radiology ... #Cysts #Differential ... #Comparison #Table ... #RadiologyAssistant
The fourth pattern includes abnormalities that result in decreased lung attenuation or air-filled lesions.
These include:
- Emphysema
-
The fourth pattern ... Langerhans cell histiocytosis ... #Diagnosis #Radiology ... LowAttenuation #Differential ... Emphysema #SignetRing #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 ... #Comparison #Table ... #RadiologyAssistant
Cystic versus Reticular
It can be difficult to determine whether we are dealing with a reticular pattern
or a cystic pattern ... The CXR is of a ... Langerhans cell histiocytosis ... #Clinical #Radiology ... LangerhansCellHistiocytosis #LCH #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
On the left some diseases with a nodular pattern.
1. Hypersensitivity pneumonitis: ill defined centrilobular nodules.
2. Miliary
Langerhans cell histiocytosis ... before the typical cysts ... NodularPattern #Differential ... #Comparison #Table ... #RadiologyAssistant
On the left a chest film of a 19 year old patient with Langerhans cell histiocytosis.
The
is a reticular patern ... caused by multiple cysts ... #Clinical #Radiology ... #CXR #CTChest # ... #Cystic #RadiologyAssistant
Cavities frequently arise within a mass or an area of consolidation as a result of necrosis.
We
In the differential ... the surrounding lung ... Langerhans cell histiocytosis ... Clinical #Diagnosis #Radiology ... Emphysema #Comparison #RadiologyAssistant