Infection
Inflammation
Desquamative Interstitial Pneumonia (DIP) Patchy Ground Glass Changes
51-year-old female smoker with a history of COPD asthma and pulmonary hypertension presents with progressive dyspnea. Axial CT through the lower lung fields shows patchy ground glass changes in the middle lobe inferior ligula and lower lobes and some regions of mosaicism. There is evidence of thick-walled bronchiolectasis in the right lower lobe Pathology confirmed a diagnosis of DIP
Ashley Davidoff MD TheCommonVein.net 252Lu 135976
Desquamative Interstitial Pneumonia (DIP)
Patchy Ground Glass Changes and Mosaicism and
Air Trapping – Inspiration Expiration Views
51-year-old female smoker with a history of COPD asthma and pulmonary hypertension presents with progressive dyspnea. Axial CT through the right posterior recesses at end inspiration (upper panel) and end expiration (lower panel) confirms the presence of air trapping indicating the presence of mild small airway disease
Pathology confirmed a diagnosis of DIP
Ashley Davidoff MD TheCommonVein.net 252Lu 135987
Desquamative Interstitial Pneumonia
Diffuse Ground Glass Changes with
Patchy Changes more Prominent at the Lung Bases
60-year-old male smoker with a history of progressive dyspnea. Coronal CT through the posterior lung fields at the level of the vertebral column shows extensive patchy ground glass changes and mosaic attenuation. A few of the secondary lobules show prominent centrilobular nodules reflecting a small airways component but the predominant pattern is an alveolar pattern
Pathology confirmed a diagnosis of DIP
Ashley Davidoff MD TheCommonVein.net 253Lu 136014c
Inflammation
Follicular Bronchiolitis, (aka Bronchiolitis Obliterans)
70-year-old female former smoker with long standing history of RA presents with chronic dyspnea.
Axial CT of the chest at the level of the aortic arch reveals centrilobular nodules, ground-glass opacities, and mosaic attenuation (likely due to air trapping in this context) and bronchial wall thickening. In the context of a patient with rheumatoid arthritis a diagnosis of follicular bronchiolitis is likely. However radiologically fibrotic hypersensitivity pneumonitis (HP) is included in the differential diagnosis
Ashley Davidoff MD TheCommonVein.net 132Lu 136652
70-year-old female former smoker with long standing history of RA presents with chronic dyspnea.
Axial CT of the chest at the level of the aortic arch reveals centrilobular nodules (b, white arrowheads) , ground-glass opacities, and mosaic attenuation (b, white rings) likely due to air trapping in this context, and bronchial wall thickening (b, c teal rings). There is some irregular thickening of the interlobular septa. In the context of a patient with rheumatoid arthritis a diagnosis of follicular bronchiolitis is likely. However radiologically fibrotic hypersensitivity pneumonitis (HP) is included in the differential diagnosis
Ashley Davidoff MD TheCommonVein.net 132Lu 136652cL
70-year-old female former smoker with long standing history of RA presents with chronic dyspnea.
Axial CT of the chest at the level of the lower lung fields reveals centrilobular nodules (b white arrowheads), ground-glass opacities, and mosaic attenuation (b, white rings) likely due to air trapping in this context.
In the context of a patient with rheumatoid arthritis a diagnosis of follicular bronchiolitis is likely. However radiologically fibrotic hypersensitivity pneumonitis (HP) is included in the differential diagnosis
Ashley Davidoff MD TheCommonVein.net 132Lu 136657cL
70-year-old female former smoker with long standing history of RA presents with chronic dyspnea.
CT in the coronal plane of the chest at the level of the spine reveals bilateral diffuse changes in the lungs characterized by centrilobular nodules, ground-glass opacities, mosaic attenuation (likely due to air trapping in this context) and irregular thickening of the interlobular septa.
In the context of a patient with rheumatoid arthritis a diagnosis of follicular bronchiolitis is likely. However radiologically fibrotic hypersensitivity pneumonitis (HP) is included in the differential diagnosis
Ashley Davidoff MD TheCommonVein.net 132Lu 136663
70-year-old female former smoker with long standing history of RA presents with chronic dyspnea.
CT in the coronal plane of the chest at the level of the spine reveals bilateral diffuse changes in the lungs characterized by centrilobular nodules, ground-glass opacities, mosaic attenuation (likely due to air trapping in this context) and irregular thickening of the interlobular septa.
In the context of a patient with rheumatoid arthritis a diagnosis of follicular bronchiolitis is likely. However radiologically fibrotic hypersensitivity pneumonitis (HP) is included in the differential diagnosis
Ashley Davidoff MD TheCommonVein.net 132Lu 136664
Malignancy Mechanical/Atelectasis Trauma Metabolic Circulatory- Hemorrhage Immune Infiltrative Idiopathic Iatrogenic Idiopathic
CHF
50-year-old female with diabetes, chronic renal failure and congestive heart failure. CT in the axial plane through the right posterior recess, shows thickened interlobular septa at the right base, congested arterioles (light blue arrowheads, b), alongside the bronchioles, peribronchial cuffing (white arrowheads, b), a congested pulmonary venule in the interlobular septum (red arrowhead arrowheads, b), ground glass changes and a secondary lobule demonstrating mosaic attenuation (black arrowhead arrowheads, b). The IVC is dilated and a small complex effusion is present.
Ashley Davidoff MD TheCommonvein.net 135783cL 193Lu
50-year-old female with diabetes, chronic renal failure with congestive heart failure. CT in the coronal plane shows diffuse ground glass changes, Kerley B lines, edema in the fissure, peribronchial cuffing, enlargement of the pulmonary artery, and mosaic attenuation
Ashley Davidoff MD TheCommonvein.net 135778c 193Lu
Thickened Interlobular Septa
81F hx atrial fibrillation cardiac failure heart failure CHF RA enlarged LA enlarged ground glass mosaic perfusion Kerley B lines
Ashley Davidoff MD
TheCommonVein.net
44194b01
Small Airways are filled with mucus in a patient with COPD – Note centrilobular impaction of mucus Small Airways are obstructed and air is trapped
Ashley Davidoff TheCommonVein.net bronchioles 001