- •Preface
- •Contents
- •Pattern Approach for Lung Imaging
- •1: Nodule
- •Solitary Pulmonary Nodule (SPN), Solid
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Lung Cancer (Solid Adenocarcinoma)
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Carcinoid or Atypical Carcinoid
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •BALT Lymphoma
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Tuberculoma
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Hamartoma
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Sclerosing Hemangioma
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Ground-Glass Opacity Nodule
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Atypical Adenomatous Hyperplasia (AAH)
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Adenocarcinoma in Situ (AIS)
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Minimally Invasive Adenocarcinoma (MIA)
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •2: Mass
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Pulmonary Sarcoma
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Progressive Massive Fibrosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pulmonary Actinomycosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •3: Consolidation
- •Lobar Consolidation
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Lobar Pneumonia
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Invasive Mucinous Adenocarcinoma
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pulmonary Infarction
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Patchy and Nodular Consolidation
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Airway-Invasive Pulmonary Aspergillosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pulmonary Cryptococcosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •IgG4-Related Lung Disease
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Lymphomatoid Granulomatosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •4: Beaded Septum Sign
- •Diseases Causing the Sign
- •Distribution
- •Clinical Considerations
- •References
- •5: Comet Tail Sign
- •Diseases Causing the Sign
- •Distribution
- •Clinical Considerations
- •Rounded Atelectasis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •6: CT Halo Sign
- •Diseases Causing the Sign
- •Distribution
- •Clinical Considerations
- •Angioinvasive Pulmonary Aspergillosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Metastatic Hemorrhagic Tumors
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pulmonary Endometriosis with Catamenial Hemorrhage
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •7: Galaxy Sign
- •Diseases Causing the Sign
- •Distribution
- •Clinical Considerations
- •Galaxy Sign in Pulmonary Tuberculosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •8: Reversed Halo Sign
- •Diseases Causing the Sign
- •Distribution
- •Clinical Considerations
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pulmonary Mucormycosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Lymphomatoid Granulomatosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •9: Tree-in-Bud Sign
- •Diseases Causing the Sign
- •Distribution
- •Clinical Considerations
- •Aspiration Bronchiolitis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Foreign-Body-Induced Pulmonary Vasculitis (Cellulose and Talc Granulomatosis)
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •Diseases Causing the Sign
- •Distribution
- •Clinical Considerations
- •Bronchial Atresia
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Bronchial Tuberculosis and Mucoid Impaction
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Foreign-Body Aspiration
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Allergic Bronchopulmonary Aspergillosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •11: Lobar Atelectasis Sign
- •Disease Causing the Sign
- •Distribution
- •Clinical Considerations
- •Right Upper Lobar Atelectasis
- •Left Upper Lobar Atelectasis
- •Right Middle Lobar Atelectasis
- •Lower Lobar Atelectasis
- •References
- •Cavity
- •Diseases Causing the Cavity
- •Distribution
- •Clinical Considerations
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT-Pathology Comparisons
- •Patient Prognosis
- •Langerhans Cell Histiocytosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT-Pathology Comparisons
- •Patient Prognosis
- •Septic Pulmonary Embolism
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT-Pathology Comparisons
- •Patient Prognosis
- •Cavitary Pulmonary Tuberculosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT-Pathology Comparisons
- •Patient Prognosis
- •Paragonimiasis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT-Pathology Comparisons
- •Patient Prognosis
- •Cyst
- •Diseases Causing the Cyst
- •Distribution
- •Clinical Considerations
- •Blebs and Bullae
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT-Pathology Comparisons
- •Patient Prognosis
- •Pulmonary Sequestration
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT-Pathology Comparisons
- •Patient Prognosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT-Pathology Comparisons
- •Patient Prognosis
- •Intrapulmonary Bronchogenic Cyst
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT-Pathology Comparisons
- •Patient Prognosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT-Pathology Comparisons
- •Patient Prognosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT-Pathology Comparisons
- •Patient Prognosis
- •Traumatic Lung Cysts
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT-Pathology Comparisons
- •Patient Prognosis
- •References
- •Mosaic Attenuation
- •Diseases Causing the Mosaic Attenuation Pattern
- •Distribution
- •Clinical Considerations
- •Cystic Fibrosis
- •Pathology and Pathogenesis
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Constrictive Bronchiolitis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Chronic Pulmonary Thromboembolism
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Idiopathic Pulmonary Arterial Hypertension
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Airway Disease (Bronchiectasis and Bronchiolectasis)
- •Distribution
- •Clinical Considerations
- •Swyer-James-MacLeod Syndrome
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Dyskinetic Cilia Syndrome
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •14: Air-Crescent Sign
- •Diseases Causing the Sign
- •Distribution
- •Clinical Considerations
- •Aspergilloma
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Rasmussen’s Aneurysm
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •15: Signet Ring Sign
- •Diseases Causing the Sign
- •Distribution
- •Clinical Considerations
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •16: Interlobular Septal Thickening
- •Smooth Septal Thickening
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Pulmonary Edema
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT-Pathology Comparisons
- •Patient Prognosis
- •Niemann–Pick Disease
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT-Pathology Comparisons
- •Patient Prognosis
- •Nodular Septal Thickening
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Pulmonary Lymphangitic Carcinomatosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT-Pathology Comparisons
- •Patient Prognosis
- •References
- •17: Honeycombing
- •Honeycombing with Subpleural or Basal Predominance
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Asbestosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Honeycombing with Upper Lung Zone Predominance
- •Diseases Causing the Pattern and Distribution
- •Distribution
- •Clinical Considerations
- •Idiopathic Familial Pulmonary Fibrosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Chronic Hypersensitivity Pneumonia
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •End-stage Fibrotic Pulmonary Sarcoidosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •18: Small Nodules
- •Small Nodules with Centrilobular Distribution
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Mycoplasma Pneumoniae Pneumonia
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Diffuse Panbronchiolitis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Follicular Bronchiolitis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pulmonary Tumor Embolism
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Pneumoconiosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pulmonary Sarcoidosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pulmonary Alveoloseptal Amyloidosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Small Nodules with Random (Miliary) Distribution
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Miliary Tuberculosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Miliary Metastasis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •19: Multiple Nodular or Mass(-like) Pattern
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Pulmonary Metastasis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pulmonary Lymphoma
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Amyloidomas
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •ANCA-Associated Granulomatous Vasculitis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •Ground-Glass Opacity with Reticulation and Fibrosis
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Ground-Glass Opacity with Reticulation, but without Fibrosis (Crazy-Paving Appearance)
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Pneumocystis jirovecii Pneumonia
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Lipoid Pneumonia
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pulmonary Alveolar Proteinosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Mucinous Adenocarcinoma or Adenocarcinoma in Situ, Diffuse Form
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Desquamative Interstitial Pneumonia
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Ground-Glass Opacity without Reticulation, with Small Nodules
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Subacute Hypersensitivity Pneumonitis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Cytomegalovirus Pneumonia
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Diffuse Alveolar Hemorrhage
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Ground-Glass Opacity without Reticulation, Diffuse Distribution
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Acute Hypersensitivity Pneumonitis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Acute Eosinophilic Pneumonia
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •22: Consolidation
- •Consolidation with Subpleural or Patchy Distribution
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Cryptogenic Organizing Pneumonia
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Chronic Eosinophilic Pneumonia
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Churg–Strauss Syndrome
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Radiation Pneumonitis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Consolidation with Diffuse Distribution
- •Diseases Causing the Pattern
- •Distribution
- •Clinical Considerations
- •Viral Pneumonias
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Acute Interstitial Pneumonia
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Diffuse Alveolar Hemorrhage
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •23: Decreased Opacity with Cystic Walls
- •Cavities
- •Diseases Causing Cavities
- •Distribution
- •Clinical Considerations
- •Rheumatoid Lung Nodules
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Cavitary Metastasis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Cysts
- •Diseases Causing Multiple Cysts
- •Distribution
- •Clinical Considerations
- •Lymphangioleiomyomatosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Lymphocytic Interstitial Pneumonia
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •Emphysema
- •Distribution
- •Clinical Considerations
- •Centrilobular Emphysema
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •Patient Prognosis
- •Paraseptal Emphysema
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •Patient Prognosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •Patient Prognosis
- •References
- •24: Decreased Opacity without Cystic Walls
- •Mosaic Attenuation, Vascular
- •Distribution
- •Clinical Considerations
- •Airway Diseases Causing Mosaic Attenuation
- •Distribution
- •Clinical Considerations
- •Asthma
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •Distribution
- •Clinical Considerations
- •Cystic Fibrosis
- •Pathology and Pathogenesis
- •Symptoms and Signs
- •CT Findings
- •CT–Pathology Comparisons
- •Patient Prognosis
- •References
- •26: Pneumonia
- •Lobar Pneumonia
- •Bronchopneumonia
- •Interstitial Pneumonia
- •27: Drug-Induced Lung Disease
- •Interstitial Pneumonitis and Fibrosis
- •Eosinophilic Pneumonia
- •Cryptogenic Organizing Pneumonia
- •Diffuse Alveolar Damage
- •Hypersensitivity Pneumonia
- •References
- •Systemic Lupus Erythematosus (SLE)
- •Rheumatoid Arthritis (RA)
- •Progressive Systemic Sclerosis (PSS)
- •Sjögren’s Syndrome
- •Mixed Connective Tissue Disease
- •Ankylosing Spondylitis
- •References
Kyung Soo Lee
Joungho Han
Man Pyo Chung
Yeon Joo Jeong
Radiology Illustrated
Chest Radiology
123
Radiology Illustrated: Chest Radiology
Kyung Soo Lee • Joungho Han • Man Pyo Chung Yeon Joo Jeong
Radiology Illustrated:
Chest Radiology
Kyung Soo Lee |
Man Pyo Chung |
Department of Radiology |
Department of Medicine |
Samsung Medical Center |
Division of Pulmonary and Critical Care |
Sungkyunkwan University School of Medicine |
Samsung Medical Center |
Seoul |
Sungkyunkwan University School of Medicine |
Korea, Republic of (South Korea) |
Seoul |
|
Korea, Republic of (South Korea) |
Joungho Han |
|
Department of Pathology |
Yeon Joo Jeong |
Samsung Medical Center |
Department of Radiology |
Sungkyunkwan University School of Medicine |
Pusan National University Hospital |
Seoul |
Busan |
Korea, Republic of (South Korea) |
Korea, Republic of (South Korea) |
ISSN 2196-114X |
eISSN 2196-1158 |
ISBN 978-3-642-37095-3 |
ISBN 978-3-642-37096-0 (eBook) |
DOI 10.1007/978-3-642-37096-0 |
|
Springer Heidelberg New York Dordrecht London
Library of Congress Control Number: 2013955297
© Springer-Verlag Berlin Heidelberg 2014
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To our spouses and children:
Kyung Sook Yi and Joo Hwang and Joo Young Young Hee Chon and Seung Hwan and Jae Won Seoun Min Ahn and Seung Hwan and You Seoun Youseock Jeong and Yean and Jian
Preface
Multidetector CT images of the state-of-the-art quality are increasingly produced in thoracic imaging, and in the near future, the CT imaging is expected to substitute chest radiography especially in outpatient clinic and may be ordered as a routine admission battery examination.
In MEDLINE or other search engines, writing down several keywords regarding lung diseases with correct MeSH (Medical Subject Headings) words would promptly bring you several diseases among which you may choose correct diagnosis of pulmonary diseases in consideration of most compatible patient symptoms and signs. Likewise, we authors would like to publish a book that will guide readers to correct diagnosis, when they use correct MeSH words or keywords for describing lung lesion patterns identified on chest CT images. When readers encounter similar patterns or distribution of lung abnormalities at CT, they may need to enumerate many diseases as potential differential diagnoses. This book provides the imaging algorithms based on patterns and distributions of lung lesions and the most relevant differential diagnoses. Because all diseases could not be enlisted as potential diagnostic possibilities, we tried to enumerate as many as common diseases that appear with similar patterns and distribution. Thus, familiarity with correct glossary of terms of lung lesion description is basic prerequisite for effective and helpful reading of this book and for making a correct diagnosis seen on chest CT scans.
After enlisting the diseases showing such pattern and distribution, the text provides the key points for differential diagnosis based on clinical and imaging features and tables that outline the classic manifestations of the various diseases. For each disease, succinct description of histopathology, clinical symptoms and signs, CT–pathology correlation, and patient prognosis has been given. Thus, this book is expected to be a shepherd for imaging diagnosis of lung diseases to radiology residents, fellows for thoracic imaging, chest physicians, and general practitioners. Moreover, as many cases are illustrated with their corresponding pathology, lung pathologists may also like to read this book. Like a cherishing substance, by keeping this handy book nearby and by comparing CT images of your patients with illustrated cases shown on this book, you may narrow differential diagnoses of your cases seen in patients of your references.
In mobile web and smartphone era, such automatic diagnosis App devices are expected to be developed such that taking a photograph of representative CT image of your patient CT might bring you an easy and automatic diagnosis of the lung disease of your patient. This approach may be feasible by pattern approach using cumulative image database. We wish that this book would be a cornerstone for such App (application) in the near future.
Last but not least, we should thank Young Joo Moon for her enthusiastic editorial help and Springer people, Dr. Ute Heilmann and Ms. Lauren Kim, for encouraging us to write this precious book.
Gangnam-gu, Seoul and Seo-gu, Pusan in Korea, August 2013 |
Kyung Soo Lee |
|
Joungho Han |
|
Man Pyo Chung |
|
Yeon Joo Jeong |
vii
Contents
Part I Focal Lung Diseases |
|
|
1 |
Nodule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
3 |
|
Solitary Pulmonary Nodule (SPN), Solid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
3 |
|
Lung Cancer (Solid Adenocarcinoma) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
4 |
|
Carcinoid or Atypical Carcinoid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
8 |
|
BALT Lymphoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
11 |
|
Tuberculoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
13 |
|
Hamartoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
13 |
|
Sclerosing Hemangioma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
14 |
|
Inflammatory Myofibroblastic Tumor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
14 |
|
ANCA-Associated Granulomatous Vasculitis (Former Wegener’s |
|
|
Granulomatosis) Manifesting as a Solitary Pulmonary Nodule . . . . . . . . . . . . . . . . |
14 |
|
Ground-Glass Opacity Nodule. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
15 |
|
Atypical Adenomatous Hyperplasia (AAH). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
19 |
|
Adenocarcinoma in Situ (AIS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
19 |
|
Minimally Invasive Adenocarcinoma (MIA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
19 |
|
Loeffler’s Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
20 |
|
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
22 |
2 |
Mass . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
25 |
|
Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
25 |
|
Diseases Causing the Pattern . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
25 |
|
Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
25 |
|
Clinical Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
25 |
|
Pulmonary Sarcoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
26 |
|
Progressive Massive Fibrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
29 |
|
Pulmonary Actinomycosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
31 |
|
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
31 |
3 |
Consolidation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
33 |
|
Lobar Consolidation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
33 |
|
Lobar Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
34 |
|
Invasive Mucinous Adenocarcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
35 |
|
Bronchus-Associated Lymphoid Tissue (BALT) Lymphoma. . . . . . . . . . . . . . . . . . |
38 |
|
Pulmonary Infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
39 |
|
Patchy and Nodular Consolidation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
39 |
|
Airway-Invasive Pulmonary Aspergillosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
43 |
|
Pulmonary Cryptococcosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
45 |
|
IgG4-Related Lung Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
45 |
|
Lymphomatoid Granulomatosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
46 |
|
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
46 |
ix
x |
|
Contents |
4 |
Beaded Septum Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
49 |
|
Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
49 |
|
Diseases Causing the Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
49 |
|
Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
49 |
|
Clinical Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
49 |
|
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
50 |
5 |
Comet Tail Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
51 |
|
Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
51 |
|
Diseases Causing the Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
51 |
|
Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
51 |
|
Clinical Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
51 |
|
Rounded Atelectasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
51 |
|
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
54 |
6 |
CT Halo Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
55 |
|
Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
55 |
|
Diseases Causing the Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
55 |
|
Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
55 |
|
Clinical Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
55 |
|
Angioinvasive Pulmonary Aspergillosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
56 |
|
Metastatic Hemorrhagic Tumors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
57 |
|
Pulmonary Endometriosis with Catamenial Hemorrhage. . . . . . . . . . . . . . . . . . . . . |
58 |
|
Eosinophilic Lung Disease (Parasitic Infestation) . . . . . . . . . . . . . . . . . . . . . . . . . . |
60 |
|
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
60 |
7 |
Galaxy Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
63 |
|
Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
63 |
|
Diseases Causing the Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
63 |
|
Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
63 |
|
Clinical Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
63 |
|
Galaxy Sign in Pulmonary Tuberculosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
65 |
|
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
65 |
8 |
Reversed Halo Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
67 |
|
Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
67 |
|
Diseases Causing the Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
67 |
|
Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
67 |
|
Clinical Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
67 |
|
Cryptogenic Organizing Pneumonia and Reversed Halo Sign . . . . . . . . . . . . . . . . . |
68 |
|
Pulmonary Mucormycosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
69 |
|
Lymphomatoid Granulomatosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
71 |
|
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
71 |
9 |
Tree-in-Bud Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
73 |
|
Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
73 |
|
Diseases Causing the Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
73 |
|
Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
73 |
|
Clinical Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
73 |
|
Aspiration Bronchiolitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
73 |
|
Foreign-Body-Induced Pulmonary Vasculitis (Cellulose |
|
|
and Talc Granulomatosis) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
75 |
|
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
76 |
Contents |
xi |
10 Gloved Finger Sign or Toothpaste Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
77 |
Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
77 |
Diseases Causing the Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
77 |
Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
77 |
Clinical Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
77 |
Bronchial Atresia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
77 |
Bronchial Tuberculosis and Mucoid Impaction . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
82 |
Foreign-Body Aspiration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
82 |
Allergic Bronchopulmonary Aspergillosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
83 |
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
83 |
11 Lobar Atelectasis Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
85 |
Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
85 |
Disease Causing the Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
85 |
Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
85 |
Clinical Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
85 |
Right Upper Lobar Atelectasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
92 |
Left Upper Lobar Atelectasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
92 |
Right Middle Lobar Atelectasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
93 |
Lower Lobar Atelectasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
93 |
Combined Atelectasis of the Right Middle and Lower Lobes . . . . . . . . . . . . . . . . . |
93 |
Combined Atelectasis of the Right Upper and Middle Lobes . . . . . . . . . . . . . . . . . |
93 |
Combined Atelectasis of the Right Upper and Lower Lobes . . . . . . . . . . . . . . . . . . |
93 |
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
93 |
12 Decreased Opacity with Cystic Airspace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
95 |
Cavity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
95 |
Lung Squamous Cell Carcinoma as a Cavitary Lesion. . . . . . . . . . . . . . . . . . . . . . . |
102 |
Langerhans Cell Histiocytosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
103 |
Septic Pulmonary Embolism. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
104 |
Cavitary Pulmonary Tuberculosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
104 |
Paragonimiasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
105 |
Cyst . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
105 |
Blebs and Bullae . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
111 |
Pulmonary Sequestration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
112 |
Congenital Cystic Adenomatoid Malformation . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
112 |
Intrapulmonary Bronchogenic Cyst . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
113 |
Pneumatoceles in Staphylococcal Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
113 |
Cystic Lesions in Pneumocystis jirovecii Pneumonia. . . . . . . . . . . . . . . . . . . . . . . . |
114 |
Traumatic Lung Cysts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
114 |
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
115 |
13 Decreased Opacity without Cystic Airspace. . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
117 |
Mosaic Attenuation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
117 |
Cystic Fibrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
121 |
Constrictive Bronchiolitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
123 |
Chronic Pulmonary Thromboembolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
123 |
Idiopathic Pulmonary Arterial Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
124 |
Airway Disease (Bronchiectasis and Bronchiolectasis) . . . . . . . . . . . . . . . . . . . . . |
125 |
Swyer–James–MacLeod Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
127 |
Dyskinetic Cilia Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
129 |
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
130 |
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Contents |
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14 Air-Crescent Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Diseases Causing the Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Clinical Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Aspergilloma. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
Rasmussen’s Aneurysm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
15 Signet Ring Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Diseases Causing the Sign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Clinical Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Proximal Interruption of the Right Pulmonary Artery . . . . . . . . . . . . . . . . . . . . . . . 139
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142
Part II Diffuse Lung Diseases
16 Interlobular Septal Thickening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Smooth Septal Thickening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Pulmonary Edema. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Niemann–Pick Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
Nodular Septal Thickening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
Pulmonary Lymphangitic Carcinomatosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
17 Honeycombing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Honeycombing with Subpleural or Basal Predominance . . . . . . . . . . . . . . . . . . . 153 Idiopathic Pulmonary Fibrosis/Usual Interstitial Pneumonia . . . . . . . . . . . . . . . . . . 156 Nonspecific Interstitial Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157 Asbestosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
Honeycombing with Upper Lung Zone Predominance . . . . . . . . . . . . . . . . . . . . . 158 Idiopathic Familial Pulmonary Fibrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160 Chronic Hypersensitivity Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160 End-stage Fibrotic Pulmonary Sarcoidosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
18 Small Nodules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
Small Nodules with Centrilobular Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
Mycoplasma Pneumoniae Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 Nontuberculous Mycobacterial Pulmonary Disease. . . . . . . . . . . . . . . . . . . . . . . . . 168 Diffuse Panbronchiolitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170 Follicular Bronchiolitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171 Pulmonary Tumor Embolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172
Small Nodules with Perilymphatic Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . 172 Pneumoconiosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173 Pulmonary Sarcoidosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175 Pulmonary Alveoloseptal Amyloidosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176
Small Nodules with Random (Miliary) Distribution . . . . . . . . . . . . . . . . . . . . . . . 177 Miliary Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178 Miliary Metastasis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
Contents |
xiii |
19 Multiple Nodular or Mass(-like) Pattern . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
183 |
Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
183 |
Diseases Causing the Pattern . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
183 |
Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
183 |
Clinical Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
183 |
Pulmonary Metastasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
189 |
Pulmonary Lymphoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
189 |
Pulmonary Epithelioid Hemangioendothelioma. . . . . . . . . . . . . . . . . . . . . . . . . . . . |
190 |
Amyloidomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
190 |
ANCA-Associated Granulomatous Vasculitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
191 |
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
191 |
20 Ground-Glass Opacity with Reticulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
193 |
Ground-Glass Opacity with Reticulation and Fibrosis. . . . . . . . . . . . . . . . . . . . . . |
193 |
Ground-Glass Opacity with Reticulation, but without Fibrosis |
|
(Crazy-Paving Appearance) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
195 |
Pneumocystis jirovecii Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
198 |
Lipoid Pneumonia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
199 |
Pulmonary Alveolar Proteinosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
201 |
Mucinous Adenocarcinoma or Adenocarcinoma in Situ, Diffuse Form . . . . . . . . . |
203 |
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
204 |
21 Ground-Glass Opacity without Reticulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
207 |
Ground-Glass Opacity without Reticulation, Subpleural |
|
and Patchy Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
207 |
Cellular Nonspecific Interstitial Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
210 |
Desquamative Interstitial Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
210 |
Ground-Glass Opacity without Reticulation, with Small Nodules. . . . . . . . . . . . . |
211 |
Subacute Hypersensitivity Pneumonitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
213 |
Cytomegalovirus Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
214 |
Diffuse Alveolar Hemorrhage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
214 |
Ground-Glass Opacity without Reticulation, Diffuse Distribution . . . . . . . . . . . . |
215 |
Acute Hypersensitivity Pneumonitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
217 |
Acute Eosinophilic Pneumonia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
218 |
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
218 |
22 Consolidation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
221 |
Consolidation with Subpleural or Patchy Distribution . . . . . . . . . . . . . . . . . . . . . |
221 |
Cryptogenic Organizing Pneumonia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
224 |
Chronic Eosinophilic Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
225 |
Churg–Strauss Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
225 |
Radiation Pneumonitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
226 |
Consolidation with Diffuse Distribution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
226 |
Viral Pneumonias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
230 |
Acute Interstitial Pneumonia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
231 |
Diffuse Alveolar Hemorrhage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
231 |
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
232 |
23 Decreased Opacity with Cystic Walls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
235 |
Cavities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
235 |
Rheumatoid Lung Nodules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
237 |
Cavitary Metastasis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
238 |
Cysts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
238 |
Lymphangioleiomyomatosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
241 |
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Contents |
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Lymphocytic Interstitial Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
Cystic Pulmonary Metastasis, Particularly Angiosarcoma. . . . . . . . . . . . . . . . . . . . 243
Emphysema. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 244
Centrilobular Emphysema. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
Paraseptal Emphysema . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
Panacinar Emphysema Associated with α1-Antitrypsin Deficiency . . . . . . . . . . . . 245
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248
24 Decreased Opacity without Cystic Walls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
Mosaic Attenuation, Vascular . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
Mosaic Attenuation, Obstructive Airway Disease . . . . . . . . . . . . . . . . . . . . . . . . . . 251 Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253
25 Decreased Opacity without Cystic Airspace: Airway Disease . . . . . . . . . . . . . . 255 Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255 Diseases Causing Bronchiectasis and Bronchiolectasis . . . . . . . . . . . . . . . . . . . . . . 255 Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255 Clinical Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255 Cystic Fibrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
Part III Application of Disease Pattern and Distribution, and Radiologic Signs to the Differentiation of Various Lung Diseases
26 Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261
Lobar Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261
Bronchopneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262
Interstitial Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 268
27 Drug-Induced Lung Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Interstitial Pneumonitis and Fibrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Eosinophilic Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Cryptogenic Organizing Pneumonia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270
Diffuse Alveolar Damage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
Hypersensitivity Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273
28 Interstitial Lung Disease in Collagen Vascular Disease . . . . . . . . . . . . . . . . . . . 275
Systemic Lupus Erythematosus (SLE) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275
Rheumatoid Arthritis (RA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 276
Progressive Systemic Sclerosis (PSS). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278
Polymyositis (PM) and Dermatomyositis (DM). . . . . . . . . . . . . . . . . . . . . . . . . . . . 278
Sjögren’s Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278
Mixed Connective Tissue Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 280
Ankylosing Spondylitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282