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66 Cards in this Set

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Alveolar disease
Common
--pneumonia
--aspiration
--pulmonary edema
--pulmonary hemorrhage

less common
* TB, fungus, sarcoid
* BAC, lymphoma
* Alveolar proteinosis
* COP, eosinophilic PNA
blood
pus
water
cells
protein
Peripheral consolidation
BOOP
eosinophilic PNA
pulmonary infarcts
vasculitis
septic emboli and mets
Pulmonary hemorrhage
anticoagulation, hemophilia
contusion, PE
vasculitis (Goodpasture’s, Wegener’s), CVD
infectious (TB, GNB, Aspergillus, Mucor)
drugs
bronchiectasis
tumor
Interstitial
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, BOOP, eosinophilic PNA, NF
Interstitial upper lung zone
* CF (not interstitial dz)
* Ankylosing spondylitis
* sarcoid
* silicosis
* EG
* TB
* PCP

chronic hypersensitivity pneumonitis, radiation fibrosis, chronic fungal infection
CASSETP
Interstitial dz lower lung zone
BADASS –
Bronchiectasis
Aspiration (chronic)
Drugs
Asbestosis
Scleroderma/rheumatoid lung
Sarcoid

IPF, neurofibromatosis
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
Lymphangitic carcinomatosis
What are the common primaries?
Lung
Breast
Stomach
Pancreas
Prostate
Thyroid
Hematogenous pulmonary mets
lung
breast
kidney
thyroid
colon
uterus
head&neck
testes
melanoma
lymphoma
osteosarcoma
Solitary pulmonary nodule
Inflamm - Granuloma/abscess/scar
Neoplasm- lung or mets

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
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
Miliary nodules
(3-5mm)
*TB, fungi (esp histo)
*mets (melanoma, RCC, chorioCA, thyroid)
*sarcoid, histiocytosis X
*varicella
*silicosis, talc, alveolar microlith (1mm)
Calcified nodules
*Mets (thyroid, mucinous, osteogenic)
*varicella, TB, histo, cocci
*silicosis, alveolar microlith
Peribronchovascular nodules
sarcoid
LC
KS
lymphoma
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
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
Eggshell calcifications in hilar nodes
silicosis
Coal workers' pneumoconiosis
Treated lymphoma
Granulomatous dz [Sarcoid (rare)]
Conglomerate masses
silicosis
CA
TB
fungus
sarcoid
berylliosis
Mediastinal widening
enlarged thyroid
malignant adenopathy
tortuous brachiocephalic vessels or aorta
mediastinal hemorrhage
fatty deposition (mediastinal lipomatosis)
mediastinitis
lymphoma, lung CA, thymic lesion, teratoma
Hilar mass
-TB / fungal / sarcoid
-mets / lymphoma
-PA enlargement

UNILATERAL
-Castleman’s
-bronchogenic cyst

BILATERAL
-silicosis
Superior mediastinal mass
* Thyroid or parathyroid
* Adenopathy
* Cystic hygroma
* Lymphoma, mets
* Vascular
Anterior mediastinal mass
thymic lesion (thymoma)
lymphoma (Hodgkin’s)
germ cell tumor (teratoma)
thyroid (intrathoracic goiter)

vascular (aneurysm), bronchogenic cyst, lymphangioma, hemangioma
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
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
Fatty mediastinal mass
mediastinal lipomatosis
hernia
lipoma, liposarcoma
thymolipoma
teratoma
Densely enhancing mediastinal mass
vascular, hypervascular tumors, goiters, Castleman’s
Cardiophrenic angle mass
* Fat pad (most common)
* Pericardial cyst
* Morgagni hernia
* Lymphoma, mets, lung CA,
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
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
Air crescent sign in cavity
Aspergillus
Mucor
Actinomycosis
septic emboli
Klebsiella
TB
tumors (KS)
Endobronchial
tumor (usu sq cell > small cell, carcinoid)
mets
TB
hamartoma, papilloma, hemangioma
foreign body, mucus plug, trauma
Bronchiectasis
-postinfectious (most common)
-obstruction (CA, FB),
-congenital (CF, Kartageners, immotile cilia syndr)

upper lobe – CF, TB, RTX, ABPA
Mucoid (bronchial) impaction
CF
asthma
ABPA
congenital bronchial atresia
Tracheal lumen
BIG - tracheobronchomegaly, pulm fibrosis, tracheomalacia
SMALL – saber-sheath (COPD), tracheomalacia, relapsing polychondritis, sarcoid, amyloid, Wegener’s, TB and fungal stenosis, tracheopathia osteochondroplastica
Scarring
prior TB, prior pneumonia, prior PE, prior trauma, prior surgery, radiation, fibrosis
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
Air fluid level
lung (abscess, tumor, cyst)
mediastinum (esophageal lesion, bronchogenic cyst)
pleural (hydroPTX, hemoPTX, pyoPTX)
hiatal hernia
achalasia
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
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
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
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
Chylothorax
tumor (esp lymphoma)
trauma
LAM
filariasis
iatrogenic
idiopathic
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
Calcified pleural plaques
TB
asbestos exposure
fluid (empyema, hematoma)
talc
Pleural thickening + calcification
old infection or trauma
asbestos exposure
loculated effusion /empyema
pleural mets
mesothelioma
talc
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
Elevated diaphragm
localized eventration
atelectasis
subpulmonic effusion
diaphragmatic paralysis
hernia (hiatal, Morgagni, Bochdalek)
ascites
subphrenic mass
pleural mass
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
Bronchiolitis obliterans
postinfectious
CVD (esp RA)
toxic fumes
post transplant (BMT)
lymphoma
lung CA
idiopathic
Mosaic attenuation (air trapping)
BO
sarcoid
hypersensitivity pneumonitis
chronic PE
asthma
emphysema
Small lung
hypogenetic lung syndrome
PA agenesis
chronic atelectasis
BO
Small hilum
PA compression/invasion/hypoplasia
lobar atelectasis/resection
emphysema
Enlarged cardiac silhouette
cardiomegaly
pericardial effusion
SVC syndrome
bronchogenic CA (#1)
lymphoma, mets
long term IV devices
fibrosing mediastinitis
Chronic airspace disease
bronchioloalveolar CA
lymphoma
alveolar proteinosis
alveolar sarcoid
lipoid PNA
BOOP
eosinophilic PNA
ground glass opacity on HRCT
Edema
Infection (PCP, bacterial alveolitis, viral pneumonitis)

hypersensitivity pneumonitis
BOOP
eosinophilic PNA
alveolar proteinosis
hemorrhage
lupus
reticulonodular pattern on HRCT
pulmonary edema
viral, mycoplasma, PCP
lymphangitic spread
fibrosis (IPF/drugs/RTx/CVD)
asbestosis
nodular pattern on HRCT
hematogenous infection or mets
sarcoid
pneumoconiosis (silicas, CWP)
EG
Cystic pattern on HRCT
LAM
cystic PCP
EG
honeycombing (IPF, any end-stage ILD)
interlobular septal thickening on HRCT
CHF
lymphangitic spread
alveolar proteinosis
sarcoid
centrilobular nodules on HRCT
endobronchial spread of infection or tumor (TB, MAI, bronchoPNA)
airways disease (CF, bronchiectasis, TB, MAI)
hypersensitivity pneumonitis
silicosis
histiocytosis
BOOP
pulmonary edema
talc
tree-in-bud on HRCT
endobronchial spread of infection
airways disease
perilymphatic nodules on HRCT
sarcoid
silicosis
lymphangitic spread
diffuse random nodules on HRCT
miliary TB
fungus
mets
Ddx -
Bilateral ground glass opacity emanating from hila at bases
PCP
Hypersensitivity
COP
Hemorrhage