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70 Cards in this Set

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Alveolar disease
(blood, pus, water, cells, protein)

Common
--pneumonia
--aspiration
--pulmonary edema
--pulmonary hemorrhage

less common
--TB, fungus, sarcoid, BAC, lymphoma, alv proteinosis, COP, eosinophilic PNA
None
Peripheral consolidation
COP
eosinophilic PNA
pulmonary infarcts
vasculitis
septic emboli
mets

VICE ME
Vasculitis, Infarct, COP, EPNA, Mets, Emboli
None
Pulmonary hemorrhage
anticoagulation,
hemophilia
contusion,
PE

vasculitis (Goodpasture’s, Wegener’s), CVD (collagen vasc dz)

infectious (TB, GNB, Aspergillus, Mucor)

drugs
bronchiectasis
tumor
None
Interstitial DDX complex
Edema
Infection (viral/Mycop, TB, fungi, PCP)
Pulm fibrosis
Sarcoid
*lymphangitic spread of CA
*EG
*AS, CVD,
*hypersens pneumonitis
*drugs
*silicosis, asbestos, talc
*LAM, RTx, KS, LIP, COP, eosinophilic PNA, NF
None
Interstitial upper lung zone
CASSETP
– CF (not interstitial dz)
- Ankylosing spondylitis
- sarcoid
- silicosis
- EG
- TB
- PCP
- chronic hypersensitivity pneumonitis, radiation fibrosis, chronic fungal infection
None
Interstitial dz lower lung zone
BADASS
– Bronchiectasis
- Aspiration (chronic)
- Drugs
- Asbestosis
- Scleroderma/rheumatoid lung
- Sarcoid

- IPF,
- neurofibromatosis
None
Kerley B lines
CHF lymphangitic spread of CA less common – viral, asbestos, sarcoid, lymphoma
Pulmonary fibrosis
IPF
sarcoid
pneumoconiosis, talc
histiocytosis
CVD
radiation
drugs
chronic hypersens pneumonitis
None
Lymphangitic carcinomatosis
lung breast stomach pancreas prostate thyroid
Hematogenous pulmonary mets
lung
breast
kidney
thyroid
colon
uterus
head&neck
testes
melanoma
lymphoma
osteosarcoma
None
Solitary pulmonary nodule
Inflamm - Granuloma/abscess/scar
Neoplasm- lung or

-hamartoma AVM, hematoma, infarct chest wall lesion, nipple shadow bronchial adenoma, bronchogenic cyst rheum nodule, plasma cell granuloma fissural pseudotumor rounded atelectasis, round PNA carcinoid sequestration
None
Multiple nodules
Mets,
lymphoma (usu NHL)
Granuloma (TB, fungi, sarcoid)
AVMs
Nocardia,
parasite,
septic emboli (S aureus)/ abscesses
Rheumatoid nodules,
Wegener’s
Trauma-hematoma/healed rib fxs
Silicosis
KS,
Langerhans,
PTLD
None
Miliary nodules (3-5mm)
*TB,
fungi (esp histo)
*mets (melanoma, RCC, chorioCA, thyroid)
*sarcoid,
histiocytosis X
*varicella
*silicosis, talc,
*alveolar microlith (1mm)
None
Calcified nodules
*Mets (thyroid, mucinous, osteogenic)
*varicella, TB, histo, cocci
*silicosis,
*alveolar microlith
None
Peribronchovascular nodules
sarcoid
LC
KS
lymphoma
None
Large thoracic mass
tumor (bronchogenic CA, lymphoma, mets)
infection (abscess, round PNA)
rounded atelectasis
sequestration
hematoma
extrapulmonary – fibrous tumor of pleura, loculated effusion, chest wall mass, mediast mass, AAA
None
Adenopathy
LOW DENSITY – TB / fungal infx esp in AIDS, necrotic mets, lymphoma, seminoma

VASCULAR – Castleman’s, vascular mets (carcinoid, small cell, KS, RCC, thyroid, melanoma, chorioCA)

CALCIFIED- TB, fungal, sarcoid, silicosis, lymphoma post RTx intrathoracic nodal mets –

GU (renal, test), head/neck (skin, larynx, thyroid), breast, melanoma, KS
None
Eggshell calcifications in hilar nodes
silicosis, CWP
treated lymphoma
granulomatous dz s
arcoid (rare)
None
Conglomerate masses
silicosis
CA
TB
fungus
sarcoid
berylliosis
None
Mediastinal widening
enlarged thyroid,
malignant adenopathy,
tortuous brachiocephalic vessels or aorta,
mediastinal hemorrhage,
fatty deposition (mediastinal lipomatosis),
mediastinitis,
lymphoma,
lung CA,
thymic lesion,
teratoma
None
Hilar mass
-TB / fungal / sarcoid
-mets / lymphoma
-PA enlargement

UNILATERAL
-Castleman’s
-bronchogenic cyst

BILATERAL
-silicosis
None
Superior mediastinal mass
thyroid or parathyroid
adenopathy
cystic hygroma
lymphoma,
mets
vascular
None
Anterior mediastinal mass
thymic lesion (thymoma)
lymphoma (Hodgkin’s)
germ cell tumor (teratoma) thyroid (intrathoracic goiter)
vascular (aneurysm),
bronchogenic cyst,
lymphangioma,
hemangioma
None
Middle mediastinal mass
thyroid (intrathor goiter)
esophageal lz (leiomyoma, duplic cyst)
bronchogenic cyst, pericardial cyst
vascular (aneurysm, aberrant vessel)
mets (head/neck, GU, breast, melanoma)
lung CA (small cell)
lymphoma / leukemia
KS
TB, fungus,
sarcoid
hiatal hernia
Castleman’s disease
None
Posterior mediastinal mass
NEUROGENIC (neurofibroma, schwannoma, ganglioneuroma, neuroblastoma, pheo, paraganglioma)
*ant or lat thoracic meningocele
*bronchogenic, gastroenteric, neuroenteric cyst
TB spine
paraspinal lymphoma
vascular, hematoma
extramedullary hematopoeisis
Bochdalak hernia
sequestration
mets,
sarcoid
None
Fatty mediastinal mass
mediastinal lipomatosis
hernia
lipoma, liposarcoma
thymolipoma
teratoma
None
Densely enhancing mediastinal mass
vascular,
hypervascular tumors (parathyroid),
goiters,
Castleman’s
None
Cardiophrenic angle mass
pericardial cyst,
Morgagni hernia,
lymphoma, mets, lung CA,
fat pad (most common)
None
Cyst
traumatic cyst,
hematoma cyst,
bronchogenic cyst,
hydatid cyst,
emphysematous bullae,
bronchiectasis,
end-stage interstitial disease,
sequestration,
CAM,
pneumatocele
small cystic dz – EG, LAM, cystic PCP, honeycombing, emphysema
None
Cavity
*abscess (Staph, Klebs, E coli, Pseudomonas, anaerobes)
*lung CA (usu sq cell)
*TB, fungus (blasto, cocci, histo)
*Nocardia, 2ary Aspergillus infxn of cavity
*septic emboli (Staph aureus),
lymphoma (Hodgkin’s),
rheumatoid nodule,
Wegener’s,
large hiatal hernia,
silicosis,
lymphomatoid granulomatosis,
parasites
None
Air crescent sign in cavity
Aspergillus
Mucor
Actinomycosis
septic emboli
Klebsiella
TB
tumors (KS)
None
Endobronchial
tumor (usu sq cell > small cell, carcinoid) mets
TB
hamartoma,
papilloma,
hemangioma
foreign body,
mucus plug,
trauma
None
Bronchiectasis
-postinfectious (most common)
-obstruction (CA, FB),
-congenital (CF, Kartageners, immotile cilia syndr)

upper lobe – CF, TB, RTX, ABPA
None
Mucoid (bronchial) impaction
CF
asthma
ABPA
congenital bronchial atresia
None
Tracheal lumen
BIG - tracheobronchomegaly, pulm fibrosis, tracheomalacia

SMALL – saber-sheath (COPD), tracheomalacia, relapsing polychondritis, sarcoid, amyloid, Wegener’s, TB and fungal stenosis, tracheopathia osteochondroplastica
None
Scarring
prior TB,
prior pneumonia,
prior PE,
prior trauma,
prior surgery,
prior radiation,
fibrosis
None
Calcification
granuloma (TB, fungus),
hamartoma,
lung CA,
vascular,
pleural (asbestos exposure, prior pyothorax or hemothorax),
sarcoid,
silicosis,
varicella,
mitral stenosis,
mets (bone tumor, mucinous tumors, post-chemotherapy),
alveolar microlithiasis, parasites
None
Air fluid level
lung (abscess, tumor, cyst)
mediastinum (esophageal lesion, bronchogenic cyst)
pleural (hydroPTX, hemoPTX, pyoPTX)
hiatal hernia
achalasia
None
Atelectasis
*poor diaphragm movmt, hypoventilation, PE
*central obstruction – endobronchial (CA, mucus plug, forn body)
- extrinsic (large LNs, heart, aneurysm, mediast mass)
*periph obstr – PNA, post-op (LLL after cardiac surg)
*compression – pleural fluid, PTX
*contraction – scarring - chronic TB, pulm fibrosis
None
Complete opacification of one hemithorax
- complete atelectasis (broncho CA, muc plug, lo ETT)
- large effusion (mets, lymphoma)
- prior pneumonectomy - mesothelioma
- unilateral PNA or pulm edema
None
PTX
- emphysema (ruptured bulla)
- trauma (rib fx, rupt bronch)
- iatrogenic / ventilator
- chronic interstitial lung dz or pneumoconiosis
- spontaneous
- bronchopleural fistula
- infection (Staph, PCP)
- neoplasm (met osteosarc)
- LAM
- EG
- asthma
- catamenial
None
Pneumomediastinum
asthma
trauma
alveolar rupture
ruptured bronchus or esophagus post endoscopy
Boerhaave syndrome
pos pressure ventilation
chest tube placement
ruptured abdominal viscus
post surgical
pneumo(retro)peritoneum
None
Chylothorax
tumor (esp lymphoma)
trauma
LAM
filariasis
iatrogenic
idiopathic
None
Pleural mass
mesothelioma
benign fibrous tumor
malignant thymoma/lymphoma mets (esp lung CA)
lipoma
rib tumors (kids–EG, ABC, Ewing’s, neuroblast) (adults– mets>myel>Paget’s, FD)
infection (TB, fungus, Actino)
asbestos-related
trauma / surgery
None
Calcified pleural plaques
TB
asbestos exposure
fluid (empyema, hematoma)
talc
None
Pleural thickening + calcification
old infection or trauma
asbestos exposure
loculated effusion /empyema
pleural mets, mesothelioma
talc
None
Extrapleural lesions
*CA (mets, myeloma, esp rib mets)
*infection (TB, fung, Actino)
*trauma (hematoma)
*diaphr rupture or paralysis
*pectus excavatum
*kyphoscoliosis
*cervical ribs /congen fusion of ribs
None
Elevated diaphragm
localized eventration
atelectasis
subpulmonic effusion
diaphragmatic paralysis
hernia (hiatal, Morgagni, Bochdalek)
ascites
subphrenic mass
pleural mass
None
Oligemia and/or overinflation
infection (TB, Staph pneumatocele, viral, parasite)
pulmonary HTN
asthma,
emphysema,
bullae
lobar atelect w/compensatory hyperinfl
Swyer-James syn (unilat lucent small lung)
PE (Westermark’s sign)
foreign body or mucus plug (air trapping)
lung hypoplasia
scimitar syndrome
mastectomy
congenital bronchial atresia
congenital lobar emphysema
Poland’s syn (cong absence of pec muscle)
PA stenosis/hypoplasia
None
Bronchiolitis obliterans
postinfectious
CVD (esp RA)
toxic fumes
post transplant (BMT)
lymphoma
lung CA
idiopathic
None
Mosaic attenuation (air trapping)
BO
hypersensitivity pneumonitis
chronic PE
asthma
emphysema
sarcoid
None
Small lung
hypogenetic lung syndrome
PA agenesis
chronic atelectasis
BO
None
Small hilum
PA compression/invasion/hypoplasia
lobar atelectasis/resection
emphysema
None
Enlarged cardiac silhouette
cardiomegaly
pericardial
effusion
None
SVC syndrome
bronchogenic CA (#1)
lymphoma,
mets
long term IV devices
fibrosing mediastinitis
None
Chronic airspace disease
bronchioloalveolar CA
lymphoma
alveolar proteinosis
alveolar sarcoid
lipoid PNA
BOOP/COP
eosinophilic PNA
None
ground glass opacity on HRCT
Edema
Infection (PCP, bacterial alveolitis, viral pneumonitis)
hypersensitivity pneumonitis
COP
eosinophilic PNA
alveolar proteinosis
hemorrhage
lupus
None
reticulonodular pattern on HRCT
pulmonary edema
viral,
mycoplasma,
PCP
lymphangitic spread
fibrosis (IPF/drugs/RTx/CVD)
asbestosis
None
nodular pattern on HRCT
hematogenous infection
mets
sarcoid
pneumoconiosis (silicas, CWP)
EG
None
Cystic pattern on HRCT
LAM
cystic PCP
EG
honeycombing (IPF, any end-stage ILD)
None
interlobular septal thickening on HRCT
CHF
lymphangitic spread
alveolar proteinosis
sarcoid
None
centrilobular nodules on HRCT
endobronchial spread of infection or tumor (TB, MAI, bronchoPNA)
airways disease (CF, bronchiectasis, TB, MAI)
hypersensitivity pneumonitis
silicosis
histiocytosis
COP
pulmonary edema
talc
None
tree-in-bud on HRCT
endobronchial spread of infection
airways disease
None
perilymphatic nodules on HRCT
sarcoid
lymphangitic spread
silicosis
None
diffuse random nodules on HRCT
miliary TB
fungus
mets
None
Ddx - Bilateral ground glass opacity emanating from hila at bases
PCP
Hypersensitivity
COP
Hemorrhage
None
Interstitial dz in Upper lung
TB, Silcosis, CWP
Interstital dz in the mid lung
Sarcoid,PCP. Generalized but often spare apices and bases.
Interstitial dz in the bases
interstitial fibrotic dz, lymphangitic tumor
General Interstitial ddx
*EDEMA, Most common

-TB, Silcosis, CWP,
-sarcoid, PCP,
-UIP, IPF, Drug toxicty, cvd, lymphangitic Tumor,

None of those EG