A) Pulmonary lesions:
Focal:
-Nodules.
-Masses.
-Patches.
-Cavities.
Diffuse:
-Reticular.
-Ground glass pattern.
-Nodular pattern.
-Cystic pattern.
Focal lesions:
-Nodules(Less than 3 cm).
Look to numbers, density, margin and calcification.
D.D. includes the following: Bronchogenic carcinoma, metastases, tuberculoma, Hamartoma, AVM and fungus.
-Masses (more than 3 cm).
Can be classified into solid and cystic, the solids include carcinoma and metastases while cystic include hydatid cyst.
-Patches (with air bronchograms).
Include Pneumonia, infarction, broncho-alveolar carcinoma and pulmonary contusion (history of trauma or rib fracture).
-Cavities
Look to the contents if there is
1-Fluid level, look to the surface of the fluid level, if it is straight suggests abscess, and if it is wavy it suggest ruptured hydatid cyst.
2-Only air, we look to the wall thickness, if it is thick this suggest chronic abscess, if it is thin ,here look to the site, if it is central in the lung, this should be pneumonia but if it is located peripherally and sub pleural this should be emphysematous bullae.
3- Intra cavitary soft tissue density, the most common lesion causing that appearance is the fungal ball, or then rupture hydatid cyst, break down in a tumor or blood clot(rare).
-Diffuse lesions:
1- Reticular pattern :( interlacing linear shadows appearing as a mesh or net)
-Usual interstitial pneumonia. AND U
-Acute interstitial pneumonia.
-Non specific interstitial pneumonia.
-Desquamative interstitial pneumonia.
-Idiopathic interstitial fibrosis.
-Interstitial pulmonary edema.
-Collagen vascular diseases.
-Drug indused lung diseases
-Radiation indused lung diseases
2-Ground glass pattern (increased attenuation of the lung with preserved of broncho vascular markings)
-Pneumonia.
-Acute pulmonary edema
-Pulmonary hemorrhage.
-AIDS +ground glass opacities=P.CARINII PNEUMONIA.
-Lung transplant+groung glass opacities=CMV or rejection
-Solitary ground glass opacities could be either broncho alveolar edema or carcinoma.
3-Nodular pattern (multiple rounded opacities 1-10mm)
-Random distribution as TB, fungal and deposits.
-Special distribution
@Zonal as in pneumoconiosis.
@Peri lymphatics as in Sarcoid
@Broncho-vascular as in lymphoma and leukemia.
-Cavitating nodules
@Deposits
@Wegener’s granulomatosis.
@Septic emboli
@Rheumatoid lung
4- Cystic pattern (multiple thin walled air containing lesions)
1cm or more in diameter
-Histiocytosis.
-Lymphangiolieomyomatosis.
-Lymphocytic interstitial pneumonia.
-Pneumocystis carinii pneumonia
-Centri lobular emphysema
Focal:
-Nodules.
-Masses.
-Patches.
-Cavities.
Diffuse:
-Reticular.
-Ground glass pattern.
-Nodular pattern.
-Cystic pattern.
Focal lesions:
-Nodules(Less than 3 cm).
Look to numbers, density, margin and calcification.
D.D. includes the following: Bronchogenic carcinoma, metastases, tuberculoma, Hamartoma, AVM and fungus.
-Masses (more than 3 cm).
Can be classified into solid and cystic, the solids include carcinoma and metastases while cystic include hydatid cyst.
-Patches (with air bronchograms).
Include Pneumonia, infarction, broncho-alveolar carcinoma and pulmonary contusion (history of trauma or rib fracture).
-Cavities
Look to the contents if there is
1-Fluid level, look to the surface of the fluid level, if it is straight suggests abscess, and if it is wavy it suggest ruptured hydatid cyst.
2-Only air, we look to the wall thickness, if it is thick this suggest chronic abscess, if it is thin ,here look to the site, if it is central in the lung, this should be pneumonia but if it is located peripherally and sub pleural this should be emphysematous bullae.
3- Intra cavitary soft tissue density, the most common lesion causing that appearance is the fungal ball, or then rupture hydatid cyst, break down in a tumor or blood clot(rare).
-Diffuse lesions:
1- Reticular pattern :( interlacing linear shadows appearing as a mesh or net)
-Usual interstitial pneumonia. AND U
-Acute interstitial pneumonia.
-Non specific interstitial pneumonia.
-Desquamative interstitial pneumonia.
-Idiopathic interstitial fibrosis.
-Interstitial pulmonary edema.
-Collagen vascular diseases.
-Drug indused lung diseases
-Radiation indused lung diseases
2-Ground glass pattern (increased attenuation of the lung with preserved of broncho vascular markings)
-Pneumonia.
-Acute pulmonary edema
-Pulmonary hemorrhage.
-AIDS +ground glass opacities=P.CARINII PNEUMONIA.
-Lung transplant+groung glass opacities=CMV or rejection
-Solitary ground glass opacities could be either broncho alveolar edema or carcinoma.
3-Nodular pattern (multiple rounded opacities 1-10mm)
-Random distribution as TB, fungal and deposits.
-Special distribution
@Zonal as in pneumoconiosis.
@Peri lymphatics as in Sarcoid
@Broncho-vascular as in lymphoma and leukemia.
-Cavitating nodules
@Deposits
@Wegener’s granulomatosis.
@Septic emboli
@Rheumatoid lung
4- Cystic pattern (multiple thin walled air containing lesions)
1cm or more in diameter
-Histiocytosis.
-Lymphangiolieomyomatosis.
-Lymphocytic interstitial pneumonia.
-Pneumocystis carinii pneumonia
-Centri lobular emphysema
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