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Patterns of Lung Disease

  • Ronald L. Eisenberg
Chapter

Abstract

This chapter describes the two major categories and appearances of lung disease (air space, interstitial), as well as other classic patterns and signs (ground-glass opacity, tree-in-bud pattern, mosaic attenuation, and the silhouette and spine signs).

Keywords

Air-space disease Interstitial disease Ground-glass opacity Tree-in-bud pattern Mosaic attenuation Silhouette sign Spine sign 

Supplementary material

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Fig. e3.1 Air-space disease. (a) Widespread opacification of the left lung with extensive air bronchograms in a patient with diffuse alveolar proteinosis [2] (TIF 1199 kb)
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Fig. e3.1 Air-space disease. (b) Diffuse air-space consolidation bilaterally with extremely prominent air bronchograms, due to radiation pneumonitis [3] (TIF 648 kb)
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Fig. e3.2 Interstitial disease (lymphangitic metastases). Diffuse prominence of interstitial marking bilaterally (TIF 774 kb)
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Fig. e3.3 Air-space disease (batwing appearance of pulmonary edema). (a) Diffuse alveolar filling throughout both lungs, with characteristic sparing of the outermost portions (TIF 1320 kb)
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Fig. e3.3 Air-space disease (batwing appearance of pulmonary edema). (b) Diffuse alveolar filling throughout both lungs, with characteristic sparing of the outermost portions (TIF 649 kb)
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Fig. e3.4 Air-space disease (pulmonary hemorrhage). (a) Diffuse alveolar/ground-glass opacifications (arrows) in the lower lobes bilaterally (TIF 1752 kb)
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Fig. e3.4 Air-space disease (pulmonary hemorrhage). (b) Diffuse alveolar/ground-glass opacifications (arrows) in the lower lobes bilaterally (TIF 531 kb)
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Fig. e3.5 Air-space disease (pneumonia). (a) Ill-defined, heterogeneous consolidation at the right base (arrow) [1] (TIF 688 kb)
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Fig. e3.5 Air-space disease (pneumonia). (b) In another patient, there is a focal consolidation with air bronchograms (arrow) in the lingula [3] (TIF 793 kb)
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Fig e3.6 Air-space disease (aspiration). (a) Bilateral ill-defined, patchy areas of consolidation in the lower lobes (arrows) [3] (TIF 1362 kb)
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Fig e3.6 Air-space disease (aspiration). (b) In another patient, there are ill-defined areas of opacification in the left lung (arrow) [4] (TIF 559 kb)
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Fig. e3.7 Interstitial pulmonary edema. Loss of the normal sharp definition of pulmonary vascular markings. Horizontal lines of increased opacity (Kerley B lines) represent fluid in the interlobular septa [1] (TIF 664 kb)
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Fig. e3.8 Interstitial fibrosis. (a) Coarse reticular pattern with intervening small areas of lucency produces the appearance of honeycomb lung [1] (TIF 828 kb)
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Fig. e3.8 Interstitial fibrosis. (b) Diffuse coarse reticular opacities and honeycombing (arrows) in another patient [5] (TIF 1216 kb)
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Fig. e3.9 Lymphangitic metastases. (a) Coarse prominence of interstitial markings bilaterally (TIF 1482 kb)
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Fig. e3.9. Lymphangitic metastases. (b) Coarse prominence of interstitial markings bilaterally (TIF 839 kb)
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Fig. e3.10 Hematogenous metastases. Innumerable military nodules distributed randomly throughout both lungs. These represented pulmonary metastases from a spiculated and cavitated primary bronchogenic carcinoma in the right lower lobe (arrow) [1] (TIF 665 kb)
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Fig. e3.11 Sarcoidosis. Diffuse reticulonodular pattern widely distributed throughout both lungs [1] (TIF 650 kb)
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Fig. e3.12 Sarcoidosis. Diffuse nodular opacifications throughout both lungs in a centrilobular and peribronchovascular distribution (arrows) [6] (TIF 1285 kb)
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Fig. e3.13 Silhouette sign. (a) Increased opacification at the right base medially silhouettes both the right heart border and the right hemidiaphragm (TIF 1612 kb)
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Fig. e3.13 Silhouette sign. (b) Lateral view shows areas of opacification both anteriorly and posteriorly, confirming that there is pneumonia involving both the right middle and lower lobes (TIF 2200 kb)

References

  1. 1.
    Eisenberg RL. Clinical Imaging: An Atlas of Differential Diagnosis. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2010.Google Scholar
  2. 2.
    Eisenberg RL, Johnson NM, editors. Comprehensive Radiographic Pathology. 6th ed. St. Louis: Elsevier/Mosby; 2016.Google Scholar
  3. 3.
    Franquet E. Pneumonia. Semin Roentgenol. 2017;52:27–34.CrossRefGoogle Scholar
  4. 4.
    Ridge CA, Bankier AA, Eisenberg RL. Mosaic attenuation. AJR. 2011;197:W970–7.CrossRefGoogle Scholar
  5. 5.
    Nemec SF, Bankier AA, Eisenberg RL. Lower lobe-predominant diseases of the lung. AJR. 2013;200:712–28.Google Scholar
  6. 6.
    Nemec SF, Bankier AA, Eisenberg RL. Upper lobe-predominant diseases of the lung. AJR. 2013;200:W222–37.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Ronald L. Eisenberg
    • 1
  1. 1.Department of RadiologyBeth Israel Deaconess Medical CenterBostonUSA

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