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162 Cards in this Set
- Front
- Back
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CXR
No cardiomegaly LAE |
Mitral stenosis
Restricted LV compliance - restrictive CM - hypertrophic CM - constrictive pericarditis |
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CXR
No cardiomegaly Aortic Enlargment |
Aortic stenosis
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CXR
No cardiomegaly No LAE No Aortic Enlargment |
Acute MI (pulmonary edema)
Restricted LV compliance - restrictive CM - hypertrophic CM - constrictive pericarditis |
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CXR
Cardiomegaly LAE |
Mitral regurgitation
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CXR
Cardiomegaly No LAE Aortic Enlargment |
Aortic regurgitation
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CXR
Cardiomegaly No LAE No Aortic Enlargment |
Tricuspid Regurgitation
Dilated CM Pericardial effusion Ischemic CM RV failure |
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"Wall to wall" heart
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TR
Pericardial effusion Dilated CM |
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No cardiomegaly
Increased pulmonary vasculature Non-cyanotic |
L-R shunts
LAE w/o Aortic enlargement = VSD LAE w/ Aortic enlargement = PDA No LAE or AoE = ASD or PAPVR |
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No cardiomegaly
Normal/decreased pulmonary vasculature Cyanotic |
TOF
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Cardiomegaly
Normal/decreased pulmonary vasculature Cyanotic |
Ebstein's
Tricuspid atresia w/ restricted ASD Pulmonic stenosis TR of the newborn |
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Increased pulmonary vasculature
Cyanotic |
"T-lesions"
With narrow mediastinum = TGA Truncus arteriosus TAPVR Tricuspid atresia "Tingle ventricle" DORV/DOLV |
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Pulmonary edema
Cyanotic |
Infradiaphragmatic TAPVR
Heart stress: - anemia - hypoxia - hypocalcemia - hypoglycemia - arrythmia - hypervolemia - myocarditis Coarctation |
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Focal Narrowing of trachea
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Post-Intubation stenosis
Wegeners TB Fungal Infection Sarcoid IBD |
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Nodular trachea
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Tracheobronchopathia osteochondroplastica (ca++)
Amyloidosis (ca++) Papillomatosis Mets |
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Tracheobronchomegaly
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Mounier-Kuhn
-congenital absence or atrophy of elastic fibers Fibrotic lung dz Marfan's Ehlers-Danlos Cutis laxa |
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Tracheal mass
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90% malignant
SCC Adenoid cystic Mucoepidermoid (prox bronch > trachea) Carcinoid (avid enh.) Sarcoma Adeno Mets |
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Bronchiectasis
- findings - diseases and distributions |
Bronchiectasis
= thickened bronchi ("tram tracking") = dilated bronchi (larger than adjacent PA) BL/upper - CF - ABPA (hi density plugs) Unilater/upper - TB - XRT BL/central - Williams-Campbell (defective cartilage) RML - MAC (lady Windemere's)(+nodules, TIB, masses) Unilateral/lower - Post-infectious - post-obstructive BL/lower - AIDS-related airways dz - Kartagener's/Youngs - aspiration - hypogammiglobulinemia Syndromes: - Marfan's - Mounier-Kuhn (+bronchomegaly) - Williams- Campbell (BL central, defective cartilage) - Young's (like Kartagener's, immotile cilia) - Kartagener's (bilateral lower lobe) - Yellow nail - Swyer-James (unilateral) Alpha1 antitrypsin def. (+panacinar emph) |
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Isolated air trapping
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Asthma
BO HP |
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Tree-In-Bud opacities
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= Impacted small airways
Infection Panbronchiolitis |
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Centrilobular nodules (in terms of small airways)
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= inflammation small airways
Bronchopneumonia HP RB Follicular bronchiolitis BOOP |
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BO (findings and Ddx)
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Findings:
- mosaic atte - bronciectasis - air trapping Post Tx Post viral CVD - RA Inhalation Drugs |
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Signs of a subpulmonic pneumothorax
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Deep sulcus
Hyperlucent abdomen Sharp diaphragmatic margin Double diaphragm |
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Intrathoracic, extrapleural mass
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Mets
MM |
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Lung:
Benign calcification patterns Malignant calcification pattern |
Benign:
Popcorn Diffuse Laminar Malignant: Eccentric, stippled |
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Organisms a/w lobar consolidation
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Streptococcus pneumoniae
Klebsiella pneumoniae Legionella Mycoplasma |
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Chronic lobar consolidation
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BAC
Alveolar proteinosis Lymphoma Lipoid pneumonia "alveolar" sarcoid |
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Causes of ARDS
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Sepsis
Severe PNA Trauma Inhalational injury Drowning Drug overdose Transfusion related |
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Signs of bronchiectasis
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Tram-tracking (thickened bronchial walls)
Ring shadows |
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Findings of CF on CXR
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Hyperinflation
Bronchiectasis Bronchial wall thickening Saccular spaces Mucoid impaction |
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Cavitary lung lesion
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Neoplasm (squamous cell)
Infection (TB, abscess, aspergillus) Infarct Wegener's granulomatosus |
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Signs of a mycetoma (fungus ball)
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Air crescent sign
Associated pleural thickening |
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Right pericardial mass
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Pericardial cyst
Pericardial fat pad Morgagni's hernia Lipoma Thymolipoma Epicardial LN |
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Posterior mediastinal mass
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Neurogenic tumor (70% benign)
- peripheral nerve origin (schwannoma, neuroma) - sympathetic chain (ganglioma, ganglioneuroma, neuroblastoma) - paraganglioma (pheo, chemodectoma) Hemorrhage Infection - TB - Abscess Extramedullary hematopoeisis |
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Unilateral whiteout
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Pleural effusion (medistinal shift away)
Collapse (mediastinal shift towards) Post-pneumonectomy |
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Rib notching
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Aortic coarctation
Neurofibroma Decreased PA flow with collateralization - PA atresia/hypoplasia/stenosis - TOF - Ebstein's anomaly SVC obstruction with collateral intercostal v flow |
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Thymic masses
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Thymoma/Invasive thymoma
Thyocarcinoma Thymic cyst Thymolipoma Thymic carcinoid |
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Subcarinal mass
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LAD
- bronchogenic CA - Lymphoma - GU CA - H&N CA - breast CA Infectious LAD Sarcoid Castleman's Bronchogenic cyst LA enlargement |
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PMF
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Sarcoid
Silicosis TB |
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Eggshell calcifications, mediastinal nodes
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Treated lymphoma
Silicosis Sarcoid Histo Amyloidosis Scleroderma |
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UIP
- findings - diseases |
UIP findings
- basilar, subpleural distribution - honeycombing - irregular linear lines - traction bronchiectasis - ggo's Diseases with UIP - IPF - collagen vascular disease (i.e. scleroderma) - asbestosis - drug toxicity - RA - sarcoid - chronic hypersensitivity pneumonitis |
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NSIP
- findings - diseases |
NSIP findings
- basilar, subpleural distribution - NO honeycombing - irregular linear lines - traction bronchiectasis - ggo's - "crazy paving" - traction bronchiolectasis Diseases with NSIP - Idiopathic - Collagen vascular disease (scleroderma) - Hypersensitivity pneumonitis - Drug toxicity (gold, nitrofurantoin, amiodarone, vincristine) - Radiation |
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Ghon focus
Ranke complex |
Ghon focus is a residual calcified lung nodule after TB
Tanke complex is a Ghon focus + calcified mediastinal lymph node |
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PCWP at which interstitial edema starts
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17 mm Hg
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Pulmonary AVMs
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A/W HHT
Sx: - stroke - brain abscess - dsypnea - cyanosis 20% multiple |
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Wedge shaped, peripheral lung opacity
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Infarct (esp. if central lucency and feeding vessel)
Hemorrhage Met PNA |
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Multiple large masses
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Mets
Septic emboli Lymphoma (immuno compromised) (hot on Ga-scan) Kaposi's (immuno compromised) (cold on Ga-scan) Fungal |
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Superior mediastinal mass
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Thyroid goiter
Lymphoma Met Hemorrhage Thymic mass Lymphatic malformation |
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Chronic consolidation
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TB
BAC Lipoid pneumonia Round atx Lymphoma Alveolar proteinosis Sarcoid |
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Central endobronchial tumors
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Squamous cell
Carcinoid Harmartoma Mucoepidermoid Adenoid cystic Mets |
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Diffuse cystic lung disease
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LAM (lymphangiomyomatosis)
EG (LCH) |
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Low-density peripherally enhancing lymph nodes
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TB
Fungal infection Mets (seminoma) |
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PCP pneumonia
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XR
- Central reticulonodular pattern - ggo - may be normal on XR CT - extensive symmetric ggo, centrally > peripherally - thickened septal lines - +/- consolidation - cysts of differing sizes in UL |
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Calcified LNs
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Treated lymphoma
TB Sarcoid Fungal (histploplasmosis) Silicosis Metastatic Osteosarcoma/mucinous adeno CA |
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Pulmonary LCH
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Peribronchial nodules
Bizarre cysts Cavitary lesions Bases and costophrenic angles spared |
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Mediastinal lipomatosis
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Obesity
Steroid use Cushings |
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Chonic infiltrative lung disease - Upper Lobe Predominance
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Sarcoid
Silicosis Coal Workers pneumoconiosis Berylliosis Ankylosing spondylitis LCH |
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Malignancies a/w endobronchial metastasis
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Breast
Colon Renal Melanoma Thyroid |
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Mucoid impaction/mucocele formation
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CF
ABPA Bronchial atresia Endobronchial lesion |
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Centrilobular GGO
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Hypersensitivity pneumonitis
RB RB-ILD LCH PCP |
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Thymic hyperplasia
- MRI characteristics - DDx |
Drop on in and out of phase MR
DDx: Myasthenia gravis Post-chemotherapy/steroids Hyperthyroidism RA Scleroderma Red cell aplasia |
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Solid nodule with GGO halo
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Aspergillosis
BAC/AIS Candidiasis CMV |
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Highest chance of malignancy? Benignancy?
a) solid nodule b) ggo nodule c) mixed solid and ggo nodule |
Mixed solid and ggo nodule has highest chance of malignancy.
Solid nodule has highest chance of benignancy. |
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Peripheral consolidation
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Loeffler's syndrome aka simple pulmonary eosinophilia
- single or multiple nonsegemental UL/MLZ distribution Chronic eosinophilic pneumonia - UL predominance - "photographic negative of pulmonary edema" - rapid response to steroids - subpleural sparing Cryptogenic organizing pneumonia Infarct Vasculitis |
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Pulmonary gangrene
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Cavitation and lung parenchymal sloughing within a site of prior consolidation
Staph aureus Klebsiella TB Mucormycetes |
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Bronchiolitis obliterans
- findings - Ddx |
Bronchiolitis obliterans
- bronchial dilation (subbronchial/peribronchial fibrosis causing narrowing) - air trapping (expiratory) - mosaic perfusion DDx - lung transplant/BMT - viral infection - inhalational injury - RA - IBD |
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Slow-growing mets
Fast growing mets |
Leiomyoma (hx myomectomy or hysterectomy)
Salivary gland Thyroid GCT Sarcoma Melanoma |
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Abestosis
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Thickened septal lines
Subpleural curvilinear lines Parenchymal bands Honeycombing Subpleural dependent density |
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Tracheomalacia
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Primary:
Congenital Secondary: Post-intubation COPD Relapsing polychondritis - ear and nose involved - autoimmune destruction - diffuse thinning Trauma Infection External compression |
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Mucoid impaction
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APBA
CF TB bronchostenosis endobronchial mass bronchial atresisa |
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Solitary fibrous tumor
aka fibrous tumor of the pleura |
partially circumscribed pulmonary mass
changes in position with respiration 60% benign/40% malignant a/w hypertrophic pulmonary osteoarthropathy episodic hypoglycemia |
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Lung nodule in a post transplant patient
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Aspergillus
Nocardia PTLD - a/w EBV - hilar or mediastinal LAD Mets Primary malignancy |
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Calcified lung nodules
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Heald varicella pneumonia
Healed histoplasmosis Silicosis Metastatic disease - thyroid - breast - adenocarcinoma (colon, ovary) - osteosarcoma |
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Avidly enhancing LAD
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Castleman's
- aka angiofollicular benign LN hyperplasia) - risk for lymphomatous transformation Mets - thyroid - melanoma - carcinoid - RCC |
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Unilateral hyperlucent lung
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FB obstruction (ball-valve)
Asthma Pneumothorax Swyer-James Extrinsic bronchial mass Vascular ring Hypogenetic lung syndrome Bulla Pulmonary aplasia Poland syndrome |
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Aberrant right subclavian artery
- Sx a/w? - prevalence? |
Dysphagia lusoria
1% |
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Diffuse GGO
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Diffuse GGO:
Hypersensitivity pneumonitis Pulmonary edema Pulmonary hemorrhage Atypical infection (PCP, CMV) |
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Idiopathic interstitial pneumonias (7)
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Idiopathic interstitial pneumonias
- UIP - NSIP - COP - RB-ILD - DIP - LIP - AIP |
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COP
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COP
Peripheral and peribronchovascular consolidation Atoll sign Irregular nodules |
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3 patterns of amiodarone toxicity
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3 patterns of amiodarone toxicity
NSIP COP - with high density sub pleural nodules ARDS |
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Peribronchovascular nodules
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Peribronchovascular nodules
Sarcoid Lymphoma Kaposi's Lymphangitic metastases |
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Multiple tracheobronchial masses
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Multiple tracheobronchial masses
Tracheobronchial papillomatosis Amyloid Mets |
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CPAM
CLO |
cystic pulmonary airway malformation
congenital lobar overinflation |
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Cysts and GGO
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Cysts and GGO
LIP PCP |
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LIP
- findings - Diseases |
Lymphocytic interstitial pneumonia
- diffuse GGO - thin walled cysts - lymphomatous transformation DDx - viral infection - Sjogrens - pernicious anemia - hepatitis - myasthenia gravis |
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Diffuse consolidation
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ACUTE
• Edema • Infection • Hemorrhage • ARDS CHRONIC • COP • Eosinophilic pneumonia • BAC (AIS) • Lymphoma • Sarcoid • Alveolar proteinosis • Lipoid pneumonia |
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Ground glass opacities
- Acute - Chronic |
Ground glass opacities
Acute • Edema • Infection • Hemorrhage • ARDS Chronic • Interstitial disease • Hypersensitivity pneumonitis • COP • Eosinophilic pneumonia • BAC (AIS) • Alveolar proteinosis • Lipoid pneumonia |
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Multiple, large chronic consolidations with air bronchograms
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Multiple, large chronic consolidations with air bronchograms
• BAC/AIS • Lymphoma • Alveolar sarcoid • COP |
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Peribronchovascular consolidation
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Peribronchovascular consolidation
• Tumors - BAC/AIS, Lymphoma • COP • Alveolar sarcoid |
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Peripheral lung lesions
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Peripheral lung lesions
• Pneumonia • Infarct • Contusion • Eosinophilic pneumonia ( Loefflers, chronic) • COP • BAC • Pleural lesions • Pulmonary neoplasms |
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Diffuse consolidation and nodules
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Diffuse consolidation and nodules
• BAC (AIS) • Sarcoidosis • Lymphoma • Infection |
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Crazy-paving
Acute Chronic Immunosuppressed |
Crazy-paving
Acute • Edema • hemorrhage • infection (PJP) • ARDS Chronic • Alveolar proteinosis • Lipoid pneumonia • BAC (AIS) Immunosuppressed • PJP |
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Lung lesion extending to soft tissue
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Lung lesion extending to soft tissue
• Neoplasms • Infections - Empyema necessitans - Actinomycosis - nocardiosis - TB |
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Solitary pulmonary nodule
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Solitary pulmonary nodule
• Granuloma • Neoplasm - Cancer - met - lymphoma • Hamartoma • Fungal infection • AVM • Infarction • Abscess • Round atelectasis • Lipoma, fibroma, leiomyoma • Lymph node • Rheumatoid, amyloid |
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Multiple large pulmonary nodules
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Multiple large pulmonary nodules
• Metastasis • Infections - Septic emboli - fungal - TB - Hydatid • Wegener's • rheumatoid • AVM |
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Large nodules with calcification
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Large nodules with calcification
• Granulomatous- TB, histo • Hamartomas - Carney’s triad - pulmonary chondroma - GIST - functioning extraadrenal paraganglioma • Mets- Mucinous, osteo/chondrosarcoma |
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Nodules in upper and middle lobes
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Nodules in upper and middle lobes
• Sarcoidosis • Silicosis • Histiocytosis |
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Centrilobular nodules
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Centrilobular nodules (NO SUBPLEURAL NODULES)
• Small airway/vascular disease • Bronchiolitis/RB • Bronchopneumonia • Endobronchial TB • MAC • HP • Endobronchial tumor (BAC/AIS) • Pneumoconiosis • Edema • hemorrhage • vasculitis |
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Random nodules
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Random nodules (DIFFUSE, UNIFORM)
• Miliary TB • Miliary Fungus • Mets - Hematogenous • Sarcoidosis |
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Perilymphatic nodules
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Perilymphatic nodules (DIFFUSE, NONUNIFORM)
• Sarcoidosis • Lymphangitic metastasis • Silicosis • CWP • Amyloidosis • LIP |
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Tree-in-bud opacities
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Tree-in-bud
INFECTION INFECTION INFECTION • Endobronchial TB or MAC • Fungal • Bronchopneumonia • Follicular bronchiolitis, panbronchiolitis • Bronchiectasis, bronchitis, asthma • CF, ABPA • Aspiration • BAC/AIS |
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Small airway disease
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Small airway disease
• Impaction - Tree in bud opacities • Inflammation - Centrilobular nodules • Obstruction - Mosaic perfusion, air trapping |
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Air trapping
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Air trapping
• Bronchiolitis obliterans • Bronchiolitis - viral - MAI • Asthma, Chronic bronchitis • Bronchiectasis, ABPA |
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Mosaic attenuation
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Vessel caliber is smaller within dark area
= Dark area is abnormal => Do expiratory phase IF Air trapping = Small airway disease • Bronchiolitis obliterans • Viral bronchiolitis • Constrictive bronchiolitis • Subacute HP • Asthma IF No air trapping = Small vessel disease • Pulmonary hypertension • Chronic PE • Vasculitis Vessel caliber is same throughout = Bright area is abnormal => Ground glass opacities differential |
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Cystic lung disease
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Cystic lung disease
• LAM • LCH • NF • Bulla • CF • HP • LIP • PJP • Honeycombing |
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Cysts with ground glass
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Cysts with ground glass
• PJP - Immunocompromised • LIP – collagen vascular disease • DIP - smokers • LAM – Females, multiple |
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Congenital cystic lesions of lung
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Congenital cystic lesions of lung
• CPAM • CLO • Intralobar sequestration • Bronchogenic cyst |
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Single cavitary lesion
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Single cavitary lesion
• TB, mycetoma • Malignancy - Irregular, thick wall • Abscess - Thinner wall, satellite nodules • Vasculitis • Sequestration • Hydatid dz |
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Multiple peripheral cavitating lesions
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Multiple peripheral cavitating lesions
• Septic emboli (IVDA) (TB, fungus, nocardia) • Cavitating metastasis (Squamous from HN/Cx TCC) • Wegener’s • Rheumatoid • LCH • Papillomatosis |
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Cavities
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Cavities
• Thick walled - cancer - abscess - vasculitis - lymphoma - mets - RA - TB • Thin walled - Post traumatic - bullae - pneumatocele - hydatid |
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Cavity in upper lobe
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Cavity in upper lobe
• TB • Fungus • Neoplasm • Wegener’s, sarcoidosis • Septic emboli |
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Cavity in Alveolar proteinosis
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Cavity in Alveolar proteinosis
• Nocardia • Aspergillus • Mucormycetes |
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Septal thickening
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Septal thickening
• Edema • Fibrosis • Nodular - Sarcoidosis - Lymphangitis - silicosis • Infection - Miliary TB |
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IIP
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UIP
• Basal/peripheral • Reticular abnormalities • Traction bronchiectasis • Honeycombing • Ground glass + NSIP • Basal predominance • Subpleural sparing; • Confluent Ground glass • Reticular lines • Traction bronchiectasis • Consolidation +/- • No honeycombing DIP • Smokers • Lower lobe • Peripheral Ground glass • Cysts RB-ILD • Upper lobe • Centrilobular nodules • Ground glass +/- • Emphysema, air trapping COP • Peribronchovascular/subpleural consolidation • Ground glass LIP • Lower lobe • Collagen vascular disease • Ground glass • Cysts • perivascular/subpleural reticular abnormalities AIP • Ground glass consolidation • Fine reticulation • Traction bronchiectasis |
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Progressive massive fibrosis
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Progressive massive fibrosis
• Silicosis, CWP, Talcosis, berylliosis • Sarcoidosis • TB, Fungal disease |
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Lower lobe fibrosis
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Lower lobe fibrosis
• UIP • Asbestosis • CVD- Scleroderma • Chronic hypersensitivity pneumonitis • Drugs |
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Upper lobe fibrosis
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Upper lobe fibrosis
• TB, Histoplasmosis • PMF - silicosis, CWP • Sarcoidosis • Cystic fibrosis • LCH • Ankylosing spondylitis • Radiation |
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Perihilar interstitial opacities
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Perihilar interstitial opacities
• Edema • Atypical infections • Lymphangitis • Sarcoidosis |
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Interstitial opacities with hilar adenopathy
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Interstitial opacities with hilar adenopathy
• Sarcoidosis • Lymphangitis • CHF • UIP |
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Interstitial opacities with increased lung volume
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Interstitial opacities with increased lung volume
• LAM • LCH • Emphysema |
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Fluid attenuation lesion in lung
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Fluid attenuation lesion in lung
• Mucus plugging • Loculated effusion • Bronchogenic cyst • Hydatid |
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Tubular opacities in lungs
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Tubular opacities in lungs
• Mucoid impaction • AVM • Varix • PAPVR |
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Mucus plugging- finger in glove
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Mucus plugging - finger in glove
• ABPA - Upper lobe, high density • Bronchial atresia - LUL, surrounded by air trapping • Asthma, bronchiectasis, CF • Endobronchial lesion |
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Unilateral increased density
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Unilateral increased density
• lung tx • Pulmonary edema - Unilateral • Lymphangitis - Volume loss - Breast - lung • sarcoid • lymphoma |
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Unilateral pulmonary edema
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Unilateral pulmonary edema
• Gravitational • Emphysema in opposite lung • Pulmonary artery/venous abnormality opp lung, e.g PE • Rapid expansion (Pneumothorax, PLEF) • Acute MR in acute MI • Recent lung transplant |
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Non cardiogenic pulmonary edema
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Non cardiogenic pulmonary edema
• Neurogenic • High-altitude • ARDS • Drugs • Toxic fumes • Near-drowning |
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Hyperlucency
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Hyperlucency
• Technical • Chest wall (mastectomy, POLAND) • Pneumothorax • Emphysema • Air trapping - FB - constrictive bronchiolitis - bronchial atresia - Intralobar sequestration • Swyer-James • Vascular - Oligemia |
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Focal lucency in lung
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Focal lucency in lung
• Bullous disease • Bronchial obstruction (FB, tumor, stricture, atresia) • Sequestration • CPAM • Oligemia |
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Pneumothorax
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Pneumothorax
• Alveolar/bulla rupture • Iatrogenic • Trauma • Bronchopleural fistula (Abscess, mets, PCP, LAM) • Spontaneous • Catamenial |
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Pneumomediastinum
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Pneumomediastinum
• Barotrauma • Ruptured esophagus - Iatrogenic - FB - Boerhave - trauma • Extension from retroperitoneum/neck |
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Pneumatocele
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Pneumatocele
• Infections - PJP - staphylococcus • Post traumatic • Barotrauma • Hydrocarbon ingestion |
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Nodular trachea
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Nodular trachea
• Papillomatosis • Mets • Tracheobronchopathia osteochondroplastica • Amyloid Nodular, calcified trachea • TO (spares posterior membrane) • Amyloid (does not spare) |
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Focal tracheal thickening, sparing of posterior wall
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Focal tracheal thickening, sparing of posterior wall
• Relapsing polychondritis • Tracheobronchopathica osteochondroplastica |
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Endobronchial mass
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Endobronchial mass
• Infection - TB - Histoplasma • broncholith • Inflammatory - Sarcoid - amyloid • FB • Neoplasms - Squamous - adenoid cystic - mucoepidermoid - carcinoid - mets (melanoma, thyroid, kidney, breast, colon) |
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Endobronchial vascular lesion
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Endobronchial vascular lesion
• Carcinoid • Vascular metastasis - Melanoma - breast • Glomus tumor |
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Bronchiectasis
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Bronchiectasis
Upper lobe • CF • Sarcoidosis • Radiation Central • ABPA • Mounier Kuhn (+tracheomegaly) • Williams-Campbell Middle lobe • MAI • Immotile cilia syndrome Peripheral Lower lobe • Infection • Aspiration • Hypogammaglobulineamia • Fibrosis • Transplant rejection Focal • Atresia • External compression • Malignancy • Broncholithiasis • Stenosis |
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Lower lobe panacinar emphysema
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Lower lobe panacinar emphysema
• Alpha-1 antitrypsin deficiency • Ritalin lung |
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Apical cap (> 6mm)
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Apical cap (> 6mm)
Unilateral •Cancer •Lymphoma from mediastinum/neck •Hematoma •Abscess from mediastinum/neck •Radiation Bilateral • Radiation • Mediastinal lipomatosis • Vascular abnormalities (coarctation) |
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Pleural masses
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Pleural masses
• Loculated effusion • Benign - Lipoma - NF - solitary fibrous tumor (60% benign) • Malignant - Mesothelioma - metastasis (lung, breast, GI, melanoma) - thymoma |
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Pleural based mass in a patient with asbestos exposure
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Pleural based mass in a patient with asbestos exposure
• Loculated effusion • Round atelectasis • Mesothelioma • Bronchogenic CA |
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Air in pleura
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Air in pleura
• Thoracentesis • Bronchopleural fistula • Gas-forming organisms |
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Fibrothorax
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Fibrothorax
• TB • Empyema • Old hemothorax |
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Bronchopleural fistula
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Bronchopleural fistula
• Trauma • Iatrogenic • Lung necrosis • Malignancy |
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Pleural uptake in PET
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Pleural uptake in PET
• Mesothelioma • Metastasis • Thymoma • Pleurodesis |
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Anterior mediastinal mass
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Anterior mediastinal mass
• Thyroid, thymus, germ cell, lymphoma • Fat • Vascular • Fluid collection • Morgagni hernia |
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Thymic hyperplasia
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Thymic hyperplasia
• Myasthenia gravis • Rebound from chemotherapy/steroids • Hyperthyroidism • Red cell aplasia |
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Middle Mediastinal masses
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Middle Mediastinal masses
• Vascular • Lymphadenopathy - Lymphoma - bronchogenic carcinoma - infection - reactive • Neoplasm - Bronchogenic - Mets • Bronchogenic cyst |
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Posterior mediastinal masses
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Posterior mediastinal masses
• Neurogenic tumor • Esophagus - Hiatal hernia - duplication cyst - tumor • Vascular • Extramedullary hematapoeisis |
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Low density nodes
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Low density nodes
• TB, MAI, HIV • Mets (SCC) • Lymphoma post treatment • Whipple’s |
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Mediastinal soft tissue
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Mediastinal soft tissue
Neoplastic infiltration • Lymphoma • Leukemia • Metastasis Inflammation • Acute mediastinitis • Fibrosing mediastinitis • Erdheim Chester disease |
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Cannonball mets
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Cannonball mets
• Colon • Testis/ovary • Renal • Osteosarcoma |
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Halo sign
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Halo sign
• Angioinvasive fungal infection - immunocompromised pts • Infections - Candida - CMV - herpes - coccidiomycosis • Tumors - Met angiosarcoma - Kaposi’s • BAC/AIS • Wegeners |
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Reverse Halo / Atoll sign
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Reverse Halo Atoll sign
• COP • Paracoccidiomycosis • Infarct |
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CT angiogram sign
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CT angiogram sign
• BAC/AIS - lobar form • Pneumonia • Pulmonary edema • Obstructive pneumonitis due to central lung tumors • Lymphoma • Mets from GI carcinomas |
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Head cheese sign
(Ground glass opacity with air trapping) |
Head cheese sign
(Ground glass opacity with air trapping) • Hypersensitivity pneumonitis • DIP • Mycoplasma • Sarcoidosis |
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Post pneumonectomy
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Post pneumonectomy
First 24 hours, postpneumonectomy side contains only air Slight shift of the mediastinum toward the pneumonectomized side Slight elevation of ipsilateral hemidiaphragm Postpneumonectomy space fills with serosanguineous fluid at rate of 2 rib spaces/day By end of 2 weeks, 80-90% of space obliterated By 4 months, complete obliteration Mediastinum gradually shifts more toward side of pneumonectomy Maximum shift at 6-8 months Failure of this ipsilateral shift almost always indicates an abnormality in the postpneumonectomy space, including: BP fistula Empyema Hemorrhage Chylothorax |
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Post pneumonectomy cavity
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Post pneumonectomy cavity
Filling too quickly • Hemorrhage • bronchopleural fistula • Chylothorax • empyema Emptying too quickly: • Bronchopleural fistula • Empyema necessitatis • Diaphragmatic rent • Incisional dehiscence |
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HIV patient - pulmonary
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HIV patient - pulmonary
• Reticulonodular opacities - PJP • Crazy paving- PJP • Pneumatoceles- PJP • GG with cysts- PJP, LIP • Multiple nodules - Infection (Fungal, TB, septic) - Neoplastic (Lymphoma, KS) • Nodules, PLEF, LN- Crypto, TB • Miliary nodules- TB, fungal, PJP • Nodules and pneumatoceles- LIP • Peribronchovascular masses- KS • Consolidation- Bacterial pneumonia, TB • Low density nodes- TB, MAI |
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TNM staging of lung cancer
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TNM staging of lung cancer
• T1 = <3cm - T1a <2cm - T1b 2-3cm • T2 = 3-7 cm - T2a 3-5 cm - T2b 5-7 cm - invasion of visceral pleura - obstructive pneumonia /atelectasis of less than 1/3rd of lung - Airway invasion > 2 cm from carina • T3- > 7 cm - invasion of parietal pleura, diaphragm, chest wall - obstructive pneumonia/atelectasis of entire lung - Airway invasion < 2 cm from carina - Satellite nodule in the same lobe • T4 - invasion of trachea, esophagus, heart, great vessels, mediastinum, vertebra - Satellite nodules in different lobe of same lung • N1- ipsilateral hilar/bronchial nodes • N2- ipsilateral mediastinal • N3- contralateral mediastinal/supraclavicular • M1a- Nodule in opposite lung; Malignant pleural effusion • M1b- Distal metastasis |
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Miliary nodules
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TB
Fungal Mets - thyroid - melanoma Sarcoid LCH |
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Air within empyema
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Iatrogenic
Bronchopleural fistula Gas-forming organism |
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Nodular pleural masses
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Mets
- lung - breast - GI - melanoma Mesothelioma Thymoma |
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b
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b
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