Faces of Peripheral Disease

Chronic Eosinophilic Pneumonia Affects the Alveoli and Alveolar Septal Interstitium 
Chronic eosinophilia is characterised by alveolar filling with eosinophils and inflammatory exudates(a) and interalveolar interstitial thickening, (overlaid in red in b). The infiltrates are classically peripherally positioned, usually upper lobes, more commonly bilateral but can be unilateral, and manifest as consolidation and or ground glass opacities.  The CT shows bilateral peripheral consolidations in the upper lobes
Ashley Davidoff MD The CommonVein.net  lungs-0775e

Infection
TB Apices

1Year Later Cavity with Aspergilloma in the left Apex and Consolidation and Abscess in the Right Apex
CXR and CT of a 54 year old male shows hyperinflation of the lungs, with large left apical cavity with aspergilloma and pneumonic consolidation and abscess formation in the apex of the right lung.  These findings are consistent with chronic pulmonary aspergillosis
Ashley Davidoff TheCommonvein.net

Inflammation
COP
UIP IPF

58 year old male with a family history of IPF Features on the CT reveal a dominant pattern of honeycombing noted in mid and lower lung zones
Ashley Davidoff MD thecommonvein.net 134900-lungs UIP

NSIP


Chronic Eosinophilic Pneumonia

Upper Lobe Peripheral Infiltrates and Interlobular Septal Thickening in the RUL
CT scan in the coronal performed 6 months ago at the time of clinical presentation shows upper lobe predominant peripheral infiltrates with small left lower lobe peripheral infiltrate Subsequent diagnosis by BAL of chronic eosinophilic pneumonia (CEP)
Ashley Davidoff TheCommonVein.net

Malignancy
Adenocarcinoma

Peripheral Carcinoma
The 3.5cms carcinoma is peripherally situated and is sub-pleural in location. It reveals fibroblastic (aka desmoplastic) effect as witnessed by the puckering of the pleura (arrow). It is remote from central bronchovascular structures and therefore remains relatively asymptomatic for an extended duration unless it causes pleuritic pain. The location and desmoplastic puckering of the pleura are characteristic of an adenocarcinoma.
Ashley Davidoff
TheCommonVein.net
32201b.81s
66F lung Adenocarcinoma with Lepidic Growth
Ashley Davidoff TheCommonVein.net


Large Cell

Mechanical/Atelectasis

Bilateral Pleural Effusions with Compressive Atelectasis
83 year old with bilateral pleural effusions, right larger than left with bibasilar compressive atelectasis. There is significant coronary calcification including left main disease and possible LAD stent. The left atrium is enlarged likely secondary to elevated left ventricular end diastolic pressure. This finding and the pleural effusions suggest CHF. Visualization of the wall of the aorta without the usual coarsened calcification raises the possibility of anemia
Ashley Davidoff MD TheCommonVein.net RnD image


Compressive Atelectasis

Trauma

Trauma S/p MVA
CT in the axial plane shows a peripheral air and fluid containing surrounded by a region of ground glass changes.
These findings are consistent with a hemorrhagic pneumatocele surrounded by contusion Ashley Davidoff TheCommonvein.net pneumatocele 31 M

Metabolic Circulatory- Hemorrhage Immune Infiltrative Idiopathic Iatrogenic Idiopathic

  • IPF
  • COP
    • Subpleural and Extension Along the Fissures
      •  IPF and UIP
      • NSIP
  • Chronic Eosinophilic Pneumonia