Nodules Micronodules

Transbronchial Spread of TB with Extensive Tree in Bud Changes Masquerading as Miliary TB
CT Active TB Cavitation and Ipsilateral Transbronchial Spread with Extensive Tree in Bud Pattern 
39-year-old immigrant Vietnamese male presents night sweats fever and cough
CXR shows a cavitating lesion in the apex of the right lung (magnified lower image, right) associated with an ipsilateral micronodular pattern (magnified lower image, left)
Although the right lung has the appearance of a “miliary” pattern, this term is usually referred to the hematogenous spread of the disease
Ashley Davidoff MD TheCommonvein.net 131708cL
CT Active TB Cavitation and Ipsilateral Transbronchial Spread with Extensive Tree in Bud Pattern
39-year-old immigrant Vietnamese male presents night sweats, fever, and cough. CT in the coronal plane of the chest shows a large cavitating lesion in the right upper lobe, with innumerable micronodules dominantly in the right midlung field, and to lesser extent in the right upper lung field. Some micronodules are probably present in the left lower lobe as well. Close to the largest subsegmental consolidation there is a bronchus which shows thickening of its wall.
Although it has the appearance has a “miliary” pattern, this term is usually referred to the hematogenous spread of the disease
Ashley Davidoff MD TheCommonvein.net 135786c
006Lu
CT Active TB Transbronchial Spread with Extensive Tree in Bud Changes
39-year-old immigrant Vietnamese male presents night sweats fever and cough. CT in the axial plane through the mid chest shows innumerable micronodules resulting from transbronchial spread with resultant tree in bud pattern scattered through the right lung (magnified in the right lower image). There are minimal similar changes in the lingula (magnified left lower image)..
Ashley Davidoff MD TheCommonvein.net 135789c 006Lu

Acute Miliary Histoplasmosis

CAVITATING LUNG NODULE – ACUTE PULMONARY HISTOPLASMOSIS
22-year-old female presents with flu like symptoms.  3 weeks later a chest CT shows a cavitating nodule in the left upper lobe, and extensive diffuse bilateral micronodular miliary disease.
Ashley Davidoff MD Ashley Davidoff MD TheCommonVein.net 131706
MILIARY NODULES – ACUTE PULMONARY HISTOPLASMOSIS
22-year-old female presents with flu like symptoms.  CT shows  extensive diffuse bilateral micronodular miliary disease.
Ashley Davidoff MD Ashley Davidoff MD TheCommonVein.net 131707
MILIARY NODULES – ACUTE PULMONARY HISTOPLASMOSIS
22-year-old female presents with flu like symptoms.  CT shows  extensive diffuse bilateral micronodular miliary disease with ground glass changes at the bases with suggestion of thickening of the interlobular septa.
Ashley Davidoff MD TheCommonVein.net 131710
CAVITATING LUNG NODULE – and DIFFUSE MILIARY DISEASE IN ACUTE PULMONARY HISTOPLASMOSIS
22-year-old female presents with flu like symptoms.  CT shows  left apical cavitating nodule and extensive diffuse bilateral micronodular miliary disease.
Ashley Davidoff MD TheCommonVein.net 131716

 

ACUTE PULMONARY HISTOPLASMOSIS – PNEUMONIA
22-year-old female presented with flu like symptoms 1 week prior had a CT that showed extensive diffuse bilateral micronodular military disease associated with mediastinal lymphadenopathy, and hepatosplenomegaly.
The current CXR 1 week later she required admission to the ICU and the CXR above shows  confluent pneumonic infiltrates with air bronchograms in the lower lobes.  Ashley Davidoff MD TheCommonVein.net 131721