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Radiology
Diffuse Lung Disease
Built from Fundamentals of Diagnostic Radiology
What’s inside
11 sections · 147 slides
Overview
- What diffuse lung disease is
- Roadmap
The Pulmonary Interstitium and CT Signs
Normal lobular anatomy, how thin-section CT shows disease, and the signs to recognize
- Acronyms for diffuse lung diseases
- Acronyms for diffuse lung diseases (continued)
- Why thin-section CT matters
- Utility of thin-section CT in chronic interstitial lung disease
- The pulmonary interstitium
- The secondary pulmonary lobule
- The secondary pulmonary lobule
- Normal thin-section CT lobular anatomy
- Normal thin-section CT findings
- Reading the signs of interstitial disease
- Thin-section CT findings in interstitial lung disease
- Differential diagnostic CT features in interstitial lung disease
- Differential diagnostic CT features in interstitial lung disease (continued)
- Interlobular (septal) lines
- Interlobular (septal) lines in lymphangitic carcinomatosis
- Intralobular lines and thickened fissures
- Interstitial thickening
- Thickened bronchovascular structures
- Thickened bronchovascular structures in lymphangitic carcinomatosis
- Centrilobular (lobular core) abnormalities
- Centrilobular ground-glass nodules in subacute hypersensitivity pneumonitis
- Subpleural lines and parenchymal bands
- Honeycomb cysts
- Honeycomb lung in usual interstitial pneumonia
- Thin-walled cysts
- Thin-walled cysts in lymphangioleiomyomatosis
- Irregularity of lung interfaces
- Micronodules
- Nodules and a conglomerate mass in silicosis
- Ground-glass opacity
- Ground-glass opacity in acute hypersensitivity pneumonitis
- Architectural distortion and traction bronchiectasis
- Architectural distortion and traction bronchiectasis in UIP
- Conglomerate masses and consolidation
- Consolidation in cryptogenic organizing pneumonia
Chronic Interstitial Lung Disease
Edema and the connective tissue diseases that scar the lung
- Chronic interstitial lung disease
- Differential diagnostic features in chronic interstitial lung disease
- Differential diagnostic features in chronic interstitial lung disease (continued)
- Chronic interstitial pulmonary edema
- Connective tissue disease in the chest
- Manifestations of rheumatoid disease in the chest
- Rheumatoid lung disease
- Honeycombing in rheumatoid lung
- Rheumatoid nodules and pleuritis
- Rheumatoid lung disease and rheumatoid nodules
- Systemic lupus erythematosus in the chest
- Acute lupus pneumonitis
- Scleroderma (systemic sclerosis)
- Scleroderma with fibrotic nonspecific interstitial pneumonitis
- Polymyositis and dermatomyositis
- Polymyositis
- Sjögren syndrome and related disorders
- Interstitial pneumonia with autoimmune features
Idiopathic Interstitial Pneumonias
The ATS/ERS classification, fibrosing and smoking-related forms, and acute patterns
- The idiopathic interstitial pneumonias (IIPs)
- Five groups of idiopathic interstitial pneumonia
- ATS/ERS classification of idiopathic interstitial pneumonias
- Usual interstitial pneumonia (UIP)
- CT criteria for the diagnosis of UIP / IPF
- UIP imaging
- Usual interstitial pneumonia
- IPF course
- Nonspecific interstitial pneumonia (NSIP)
- Nonspecific interstitial pneumonia
- Smoking-related IIPs
- Respiratory bronchiolitis-associated ILD (RB-ILD)
- Respiratory bronchiolitis-associated interstitial lung disease
- Desquamative interstitial pneumonia (DIP)
- Desquamative interstitial pneumonia
- Acute and subacute IIPs
- Cryptogenic organizing pneumonia (COP)
- Reversed halo sign in cryptogenic organizing pneumonia
- Acute interstitial pneumonia (Hamman-Rich syndrome)
- Acute interstitial pneumonia (Hamman-Rich syndrome)
- Acute exacerbation of interstitial pneumonia
- Acute exacerbation of interstitial lung disease
- Rare and unclassifiable IIPs
- Idiopathic pleuroparenchymal fibroelastosis
Other Chronic Interstitial Lung Diseases
Neurofibromatosis, tuberous sclerosis, LAM, amyloidosis, and aspiration
- Neurofibromatosis type 1
- Tuberous sclerosis
- Lymphangioleiomyomatosis (LAM)
- Lymphangioleiomyomatosis
- Alveolar septal amyloidosis
- Chronic aspiration
Inhalational Disease
Pneumoconiosis from inorganic dusts and hypersensitivity pneumonitis from organic dusts
- Pneumoconiosis basics
- Two families of asbestos fibers
- Asbestosis
- Asbestosis
- Silicosis
- Simple versus complicated silicosis
- Coal worker's pneumoconiosis
- Hypersensitivity pneumonitis
- Acute versus chronic hypersensitivity pneumonitis
- Hypersensitivity pneumonitis on CT
- Chronic hypersensitivity pneumonitis
Granulomatous Diseases
Sarcoidosis, berylliosis, Langerhans cell histiocytosis, and granulomatosis with polyangiitis
- Sarcoidosis overview
- How sarcoidosis forms granulomas
- Sarcoidosis lymph node disease
- Sarcoidosis
- Sarcoidosis lung disease
- Sarcoidosis with reticulonodular opacities
- Sarcoidosis CT appearances
- CT appearances of pulmonary sarcoidosis
- Fibrotic (stage IV) sarcoidosis
- Stage IV (fibrotic) sarcoidosis
- Radiographic staging of sarcoidosis
- 75%
- Berylliosis
- Langerhans cell histiocytosis of lung
- How LCH lesions evolve
- Langerhans cell histiocytosis of lung
- Langerhans cell histiocytosis on thin-section CT
- Granulomatosis with polyangiitis (GPA)
- Granulomatosis with polyangiitis
Eosinophilic Lung Disease
Idiopathic, identifiable, and autoimmune causes of pulmonary eosinophilia
- Eosinophilic lung disease
- Eosinophilic lung disease
- Simple pulmonary eosinophilia (Löffler syndrome)
- Eosinophilic pneumonia
- Chronic and acute eosinophilic pneumonia
- Eosinophilia of known and autoimmune causes
Drug-Induced Lung Disease
Histologic patterns of toxicity and the agents that cause them
- Drug-induced lung disease
- Histologic patterns in drug-induced lung toxicity
- Histologic patterns in drug-induced lung toxicity (continued)
- Drug-induced diffuse alveolar damage
- Cytoxan-induced diffuse alveolar damage
- Drug-induced UIP and NSIP
- Usual interstitial pneumonia from nitrofurantoin
- Drug-induced organizing pneumonia
- Rituximab-induced diffuse lung disease
- Specific drug toxicities
- Amiodarone lung toxicity
- Amiodarone lung toxicity
- Other drug-related chest findings
Miscellaneous Disorders
Proteinosis, microlithiasis, ossification, AFOP, and combined fibrosis and emphysema
- Pulmonary alveolar proteinosis (PAP)
- Pulmonary alveolar proteinosis
- Alveolar microlithiasis
- Diffuse pulmonary ossification
- Acute fibrinous and organizing pneumonia (AFOP)
- Combined pulmonary fibrosis and emphysema (CPFE)
Summary
Key points to take away
- Key takeaways - CT signs
- Key takeaways - disease patterns
- The radiologist's role
- Suggested readings
- Suggested readings
- Suggested readings
- Brant and Helms' Fundamentals of Diagnostic Radiology