Faces of Pulmonary Hemorrhage

Multicentric Pulmonary Hemorrhage and Pneumonia with ANCA-associated Vasculitis 

Multicentric Pulmonary Hemorrhage and Pneumonia
71 yo m w/ a hx of recently diagnosed ANCA-associated vasculitis (diagnosed by kidney biopsy), presents with acute respiratory failure. Bronchoscopic findings were consistent with diffuse alveolar hemorrhage associated with MSSA (Methicillin Sensitive Staph Aureus ) pneumonia/bacteremia
CXR shows multicentric consolidations likely a combination of alveolar hemorrhage and pneumonia
Ashley Davidoff TheCommonVein.net
Multicentric Pulmonary Hemorrhage and Pneumonia
71 yo m w/ a hx of recently diagnosed ANCA-associated vasculitis (diagnosed by kidney biopsy), presents with acute respiratory failure. Bronchoscopic findings were consistent with diffuse alveolar hemorrhage associated with MSSA (Methicillin Sensitive Staph Aureus ) pneumonia/bacteremia.  Note Consolidation surrounded by ground glass opacity, the latter likely reflecting a hemorrhagic component
CTscan shows multicentric consolidations likely a combination of alveolar hemorrhage and pneumonia
Ashley Davidoff TheCommonVein.net
Multicentric Pulmonary Hemorrhage and Pneumonia
71 yo m w/ a hx of recently diagnosed ANCA-associated vasculitis (diagnosed by kidney biopsy), presents with acute respiratory failure. Bronchoscopic findings were consistent with diffuse alveolar hemorrhage associated with MSSA (Methicillin Sensitive Staph Aureus ) pneumonia/bacteremia.  Note Consolidation surrounded by ground glass opacity, the latter likely reflecting a hemorrhagic component
CTscan shows multicentric consolidations likely a combination of alveolar hemorrhage and pneumonia
Ashley Davidoff TheCommonVein.net

Granulomatosis with polyangiitis (GPA),
aka Wegener’s granulomatosis

Pulmonary Hemorrhage

Pulmonary Hemorrhage – Granulomatosis with Polyangiitis (GPA),  aka Wegener’s granulomatosis
35 year old male in acute renal failure and respiratory distress with hemoptysis.  CT shows multicentric segmental and subsegmental regions of consolidations and ground glass opacity in the upper and lower lobes with subpleural sparing consistent with pulmonary hemorrhage
Ashley Davidoff MD TheCommonVein.net 137273
Pulmonary Hemorrhage – Granulomatosis with Polyangiitis (GPA),  aka Wegener’s granulomatosis
35 year old male in acute renal failure and respiratory distress with hemoptysis.  CT shows multicentric segmental and subsegmental regions of consolidations and ground glass opacity in the upper and lower lobes with subpleural sparing consistent with pulmonary hemorrhage
Ashley Davidoff MD TheCommonVein.net 137275

Trauma Hemorrhage –  Resuscitation Attempts
Acinar Shadows

Acinar Nodules Post Trauma
Coronal CT following trauma and resuscitative attempts in a 37 year old female shows 2-5mm solid and ground glass nodules in both the upper and lower lobes with confluence to form subsegmental foci of consolidation in the right lower lobe and right middle lobe. There is evidence of subpleural sparing with a more central distribution. These findings are consistent with hemorrhagic foci of acinar shadows or acinar nodules following trauma
Ashley Davidoff MD TheCommonVein.net 137270 key words .lungs GGO ground glass opacities acinar shadows hemorrhage contusion post resuscitation 37F 301Lu

Acinar Shadows Subpleural Sparing

Acinar Nodules Post Trauma
Coronal CT following trauma and resuscitative attempts in a 37 year old female shows 2-5mm solid and ground glass nodules in both the upper and lower lobes with confluence to form subsegmental foci of consolidation in the right lower lobe and right middle lobe. There is evidence of subpleural sparing with a more central distribution. These findings are consistent with hemorrhagic foci of acinar shadows or acinar nodules following trauma
Ashley Davidoff MD TheCommonVein.net 137270 key words .lungs GGO ground glass opacities acinar shadows hemorrhage contusion post resuscitation 37F 301Lu

Crazy Paving

Acinar Nodules and Crazy Paving  Post Trauma
Coronal CT following trauma and resuscitative attempts in a 37 year old female shows a focus of crazy paving in the left upper lobe most likely secondary to contusion.  In addition  2-5mm  nodules in both the upper and lower lobes.  In this clinical context. these findings are consistent with hemorrhagic foci of ground glass opacities acinar shadows and crazy paving  following trauma.  
Ashley Davidoff MD TheCommonVein.net 137272  301Lu