000 Lung Hemorrhage

Unknown Etiology

Focal ground Glass Changes

60 year old female who presents with hemoptysis. Ct scan shows a focal region of ground glass change in the superior segment of the left lower lobe, abutting the fissure
Ashley Davidoff MD TheCommonVein.net
60 year old female who presents with hemoptysis. CT scan shows a focal region of ground glass change in the superior segment of the left lower lobe, abutting the fissure, likely reflecting hemorrhage
Ashley Davidoff MD TheCommonVein.net

 

Diffuse

Diffuse alveolar hemorrhage. CT scans in a 47-year-old woman with recurring hemoptysis. (a) Axial and (b) coronal images from chest CT in lung windows demonstrate widespread ground-glass opacities in both lungs (arrow).
Parekh, M et al Review of the Chest CT Differential Diagnosis of Ground-Glass Opacities in the COVID Era Radiology Vol. 297, No. 3 July 2020

 

Hemorrhage Around a Mass

Halo Sign Around a Malignant Mass
CT in the axial plane demonstrates a large, spiculated mass in the right upper lobe with surrounding halo likely reflecting hemorrhage or lymphatic edema around the mass. In addition, there is evidence of irregular interlobular septal thickening likely reflecting lymphatic invasion and indicating lymphangitis carcinomatosa. There is irregular thickening of the major fissure suggesting involvement.
Ashley Davidoff MD TheCommonVein.net 135865

 

Pulmonary Hemorrhage Hematoma Fissural Displacement Ground Glass Changes
75-year-old man on blood thinners s/p aortic valve replacement, s/p trauma, presents with hemoptysis. He was afebrile and without an elevated white count
Coronal CT of the posterior lung fields shows inferior displacement of the major fissure by a dense right upper lobe consolidation. The mass effect on the major fissure likely results from a hematoma. Lateral to the consolidation there is a combination of ground glass opacity. There is elevation of the right hemidiaphragm. Left sided pleural effusion is present
Ashley Davidoff MD TheCommonVein.net 165Lu 135860

Extensive Ground Glass Changes and Consolidation following Trauma Presents with Hemoptysis On Anticoagulation for AVR No Fever No White Count Ashley Davidoff MD TheCommonVein.net 

CXR Pulmonary Hemorrhage Ground Glass Changes and Consolidation
CXR shows an elevated right hemidiaphragm and inferior displacement of the major fissure with a dense right upper lobe consolidation. The mass effect on the major fissure likely results from a hematoma, and the hemorrhage results in air bronchograms and groundglass changes.
Skin folds manifest as bilateral pseudo-pneumothoraces. A loop recorder is noted overlying the left upper chest.
Ashley Davidoff MD TheCommonVein.net 165Lu 135849

Pulmonary Hemorrhage – Heterogeneity of the Secondary Lobule

CT Pulmonary Hemorrhage – Heterogeneity of the Secondary Lobule
75-year-old man on blood thinners s/p aortic valve replacement presents with hemoptysis s/p trauma. He was afebrile and without an elevated white count
Axial CT at the level below the carina shows medial displacement of the major fissure by a dense right upper lobe consolidation. The mass effect on the major fissure likely results from a hematoma. Anterior to the consolidation there is a combination of ground glass opacity with thickened interlobular septa, and minor region of subsegmental consolidation with air bronchograms, likely resulting from hemorrhage.
The lower panels magnify the regions of the heterogeneity of the secondary lobule with most showing ground glass changes, some normal or with mosaic attenuation (black arrowheads, c), some showing thickened smooth interlobular septa (pink arrowhead, c) and others revealing centrilobular nodules (teal arrowheads, c).
There are bilateral effusions
Ashley Davidoff MD TheCommonVein.net 165Lu 135851cL

Pulmonary Hemorrhage – Heterogeneity of the Secondary Lobule

Pulmonary Hemorrhage and the Secondary Lobule Axial CT
75-year-old man on blood thinners s/p aortic valve replacement, s/p trauma, presents with hemoptysis. He was afebrile and without an elevated white count
Axial CT at the level below the carina shows medial displacement of the major fissure by a dense right upper lobe consolidation. The mass effect on the major fissure likely results from a hematoma. Anterior to the consolidation there is a combination of ground glass opacity with thickened interlobular septa, and minor region of subsegmental consolidation with air bronchograms, likely resulting from hemorrhage.
The lower panel magnifies the regions of the heterogeneity of the secondary lobule with most showing ground glass changes (white arrowheads), some normal or with mosaic attenuation (black arrowheads), some showing thickened smooth interlobular septa (pink arrowhead), and others revealing centrilobular nodules (teal arrowhead).
There are bilateral effusions
Ashley Davidoff MD TheCommonVein.net 165Lu 135852cL

Pulmonary Hemorrhage – Heterogeneity of the Secondary Lobule

Pulmonary Hemorrhage and Heterogeneous Changes in the Secondary Lobules
75-year-old man on blood thinners s/p aortic valve replacement, s/p trauma, presents with hemoptysis. He was afebrile and without an elevated white count
Axial CT at the level below the carina at the inferior aspect of the hematoma shows heterogenous changes of the secondary lobules. The changes in the post segment of the right upper lobe (b) show significantly thickened interlobular septa (pink arrowheads) and relatively small secondary lobules caused by the compression of the hematoma. The changes in the apical segment of the lower lobe (c) show a combination of secondary lobules with ground glass changes (white arrowheads) some normal or with mosaic attenuation (black arrowheads), some showing mildly thickened smooth interlobular septa (pink arrowheads), and others revealing centrilobular nodules (teal arrowheads).
There is a right sided effusion
Ashley Davidoff MD TheCommonVein.net 165Lu 135853cL
Pulmonary Hemorrhage and Heterogeneous Changes in the Secondary Lobules
Axial CT at the level below the carina shows heterogenous changes of the secondary lobules. The changes in the post segment of the right upper lobe (a, and magnified in b) show thickened interlobular septa (pink arrowhead) and mostly relatively small secondary lobules caused by the compression of the hematoma, but also by virtue of their more centrally located position. Compare their size to the larger more peripherally located secondary lobule (purple arrowhead). There is also a combination of secondary lobules with ground glass changes (white arrowhead) some normal or with mosaic attenuation (black arrowheads), some showing mildly thickened smooth interlobular septa (pink arrowhead), and others revealing centrilobular nodules (teal arrowhead).
Ashley Davidoff MD TheCommonVein.net 165Lu 135854cL

 

Ground Glass