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66 Cards in this Set
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Alveolar disease
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Common
--pneumonia --aspiration --pulmonary edema --pulmonary hemorrhage less common * TB, fungus, sarcoid * BAC, lymphoma * Alveolar proteinosis * COP, eosinophilic PNA |
blood
pus water cells protein |
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Peripheral consolidation
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BOOP
eosinophilic PNA pulmonary infarcts vasculitis septic emboli and mets |
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Pulmonary hemorrhage
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anticoagulation, hemophilia
contusion, PE vasculitis (Goodpasture’s, Wegener’s), CVD infectious (TB, GNB, Aspergillus, Mucor) drugs bronchiectasis tumor |
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Interstitial
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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 |
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Interstitial upper lung zone
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* CF (not interstitial dz)
* Ankylosing spondylitis * sarcoid * silicosis * EG * TB * PCP chronic hypersensitivity pneumonitis, radiation fibrosis, chronic fungal infection |
CASSETP
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Interstitial dz lower lung zone
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BADASS –
Bronchiectasis Aspiration (chronic) Drugs Asbestosis Scleroderma/rheumatoid lung Sarcoid IPF, neurofibromatosis |
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Kerley B lines
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CHF
lymphangitic spread of CA less common – viral, asbestos, sarcoid, lymphoma |
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Pulmonary fibrosis
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IPF
Sarcoid Pneumoconiosis, talc Histiocytosis CVD Radiation Drugs Chronic hypersens pneumonitis |
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Lymphangitic carcinomatosis
What are the common primaries? |
Lung
Breast Stomach Pancreas Prostate Thyroid |
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Hematogenous pulmonary mets
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lung
breast kidney thyroid colon uterus head&neck testes melanoma lymphoma osteosarcoma |
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Solitary pulmonary nodule
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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 |
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Multiple nodules
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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 |
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Miliary nodules
(3-5mm) |
*TB, fungi (esp histo)
*mets (melanoma, RCC, chorioCA, thyroid) *sarcoid, histiocytosis X *varicella *silicosis, talc, alveolar microlith (1mm) |
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Calcified nodules
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*Mets (thyroid, mucinous, osteogenic)
*varicella, TB, histo, cocci *silicosis, alveolar microlith |
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Peribronchovascular nodules
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sarcoid
LC KS lymphoma |
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Large thoracic mass
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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 |
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Adenopathy
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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 |
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Eggshell calcifications in hilar nodes
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silicosis
Coal workers' pneumoconiosis Treated lymphoma Granulomatous dz [Sarcoid (rare)] |
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Conglomerate masses
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silicosis
CA TB fungus sarcoid berylliosis |
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Mediastinal widening
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enlarged thyroid
malignant adenopathy tortuous brachiocephalic vessels or aorta mediastinal hemorrhage fatty deposition (mediastinal lipomatosis) mediastinitis lymphoma, lung CA, thymic lesion, teratoma |
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Hilar mass
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-TB / fungal / sarcoid
-mets / lymphoma -PA enlargement UNILATERAL -Castleman’s -bronchogenic cyst BILATERAL -silicosis |
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Superior mediastinal mass
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* Thyroid or parathyroid
* Adenopathy * Cystic hygroma * Lymphoma, mets * Vascular |
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Anterior mediastinal mass
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thymic lesion (thymoma)
lymphoma (Hodgkin’s) germ cell tumor (teratoma) thyroid (intrathoracic goiter) vascular (aneurysm), bronchogenic cyst, lymphangioma, hemangioma |
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Middle mediastinal mass
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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 |
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Posterior mediastinal mass
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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 |
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Fatty mediastinal mass
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mediastinal lipomatosis
hernia lipoma, liposarcoma thymolipoma teratoma |
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Densely enhancing mediastinal mass
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vascular, hypervascular tumors, goiters, Castleman’s
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Cardiophrenic angle mass
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* Fat pad (most common)
* Pericardial cyst * Morgagni hernia * Lymphoma, mets, lung CA, |
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Cyst
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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 |
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Cavity
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*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 |
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Air crescent sign in cavity
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Aspergillus
Mucor Actinomycosis septic emboli Klebsiella TB tumors (KS) |
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Endobronchial
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tumor (usu sq cell > small cell, carcinoid)
mets TB hamartoma, papilloma, hemangioma foreign body, mucus plug, trauma |
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Bronchiectasis
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-postinfectious (most common)
-obstruction (CA, FB), -congenital (CF, Kartageners, immotile cilia syndr) upper lobe – CF, TB, RTX, ABPA |
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Mucoid (bronchial) impaction
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CF
asthma ABPA congenital bronchial atresia |
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Tracheal lumen
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BIG - tracheobronchomegaly, pulm fibrosis, tracheomalacia
SMALL – saber-sheath (COPD), tracheomalacia, relapsing polychondritis, sarcoid, amyloid, Wegener’s, TB and fungal stenosis, tracheopathia osteochondroplastica |
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Scarring
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prior TB, prior pneumonia, prior PE, prior trauma, prior surgery, radiation, fibrosis
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Calcification
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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
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Air fluid level
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lung (abscess, tumor, cyst)
mediastinum (esophageal lesion, bronchogenic cyst) pleural (hydroPTX, hemoPTX, pyoPTX) hiatal hernia achalasia |
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Atelectasis
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*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 |
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Complete opacification of one hemithorax
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- complete atelectasis (broncho CA, muc plug, lo ETT)
- large effusion (mets, lymphoma) - prior pneumonectomy - mesothelioma - unilateral PNA or pulm edema |
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PTX
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- 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 |
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Pneumomediastinum
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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 |
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Chylothorax
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tumor (esp lymphoma)
trauma LAM filariasis iatrogenic idiopathic |
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Pleural mass
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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 |
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Calcified pleural plaques
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TB
asbestos exposure fluid (empyema, hematoma) talc |
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Pleural thickening + calcification
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old infection or trauma
asbestos exposure loculated effusion /empyema pleural mets mesothelioma talc |
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Extrapleural lesions
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*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 |
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Elevated diaphragm
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localized eventration
atelectasis subpulmonic effusion diaphragmatic paralysis hernia (hiatal, Morgagni, Bochdalek) ascites subphrenic mass pleural mass |
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Oligemia and/or overinflation
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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 |
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Bronchiolitis obliterans
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postinfectious
CVD (esp RA) toxic fumes post transplant (BMT) lymphoma lung CA idiopathic |
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Mosaic attenuation (air trapping)
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BO
sarcoid hypersensitivity pneumonitis chronic PE asthma emphysema |
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Small lung
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hypogenetic lung syndrome
PA agenesis chronic atelectasis BO |
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Small hilum
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PA compression/invasion/hypoplasia
lobar atelectasis/resection emphysema |
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Enlarged cardiac silhouette
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cardiomegaly
pericardial effusion |
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SVC syndrome
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bronchogenic CA (#1)
lymphoma, mets long term IV devices fibrosing mediastinitis |
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Chronic airspace disease
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bronchioloalveolar CA
lymphoma alveolar proteinosis alveolar sarcoid lipoid PNA BOOP eosinophilic PNA |
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ground glass opacity on HRCT
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Edema
Infection (PCP, bacterial alveolitis, viral pneumonitis) hypersensitivity pneumonitis BOOP eosinophilic PNA alveolar proteinosis hemorrhage lupus |
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reticulonodular pattern on HRCT
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pulmonary edema
viral, mycoplasma, PCP lymphangitic spread fibrosis (IPF/drugs/RTx/CVD) asbestosis |
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nodular pattern on HRCT
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hematogenous infection or mets
sarcoid pneumoconiosis (silicas, CWP) EG |
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Cystic pattern on HRCT
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LAM
cystic PCP EG honeycombing (IPF, any end-stage ILD) |
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interlobular septal thickening on HRCT
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CHF
lymphangitic spread alveolar proteinosis sarcoid |
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centrilobular nodules on HRCT
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endobronchial spread of infection or tumor (TB, MAI, bronchoPNA)
airways disease (CF, bronchiectasis, TB, MAI) hypersensitivity pneumonitis silicosis histiocytosis BOOP pulmonary edema talc |
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tree-in-bud on HRCT
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endobronchial spread of infection
airways disease |
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perilymphatic nodules on HRCT
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sarcoid
silicosis lymphangitic spread |
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diffuse random nodules on HRCT
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miliary TB
fungus mets |
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Ddx -
Bilateral ground glass opacity emanating from hila at bases |
PCP
Hypersensitivity COP Hemorrhage |
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