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63 Cards in this Set
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PULMONARY RENAL SYNDROMES
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• Goodpasture's syndrome (anti-GBM positive)
• Wegener's disease (ANCA positive; nodules are more common than ASD) • SLE • Henoch-Schonlein purpura • Polyarteritis nodosa • Penicillamine hypersensitivity |
GSW to the HPP
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Causes of ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS)
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• Massive pneumonia
• Trauma • Shock • Sepsis • Pancreatitis • Drug overdose • Near drowning • Aspiration |
MiSSTeP DNA
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CHRONIC AIR SPACE DISEASE
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Tumors
• Bronchioalveolar carcinoma • Lymphoma Inflammation • Tuberculosis, fungus • Eosinophilic pneumonia • Pneumonitis, BOOP • Alveolar sarcoid (mimics ASD) Other causes • Alveolar proteinosis • Pulmonary hemorrhage • Lipoid pneumonia, chronic aspiration |
BLT APPLES
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4 Extrapulmonary densities which may mimic pulmonary lesions
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Artifact (nipple, skin, electrodes )
Pseudotumor (fluid in fissure) Pleural mass or plaque Rib fracture |
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SOLITARY PULMONARY NODULE
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Tumor (45%)
• Primary carcinoma, 70% • Hamartoma, 15% • Solitary metastasis, 10% Inflammation (53%); regional variations • Histoplasmoma • Tuberculoma • Coccidioidomycosis Other (2%) • Vascular, 15% AV fistula Pulmonary varix (dilated pulmonary vein) Infarct, embolism • Congenital, 30% Sequestration Bronchial cyst • Miscellaneous, 45% Round pneumonia Loculated effusion in fissure Mucous plug Enlarged subpleural lymph node Silicosis (usually multiple nodules) |
Tumor
Inflammation Other |
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MULTIPLE PULMONARY NODULES
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Mets
Abscess Granulomatous dz Infarcts |
MAGI
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Noninfectious Granulomatous lung diseases
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Sarcoid
Rheumatoid nodules Silicosis Wegener's disease Vasculitis EG |
SRSWVE
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MILIARY PATTERN
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TB
histoplasmosis Metastases (thyroid, melanoma, breast, choriocarcinoma) EG BAC Silicosis Sarcoid |
THE MBSS
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CALCIFIED LUNG NODULES
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Metastases (medullary thyroid,
Mucinous, or osteogenic) Infection (Varicella pneumonia Histo, cocci, TB) Parasites: schisto Silicosis |
MIPS
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Sand-like calcified lung nodules
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Alveolar microlithiasis
chronic pulmonary venous HTN metastatic calcification |
3
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LARGE (>6 CM) THORACIC MASS
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Pulmonary
• Tumor (Lung CA, mets) • Abscess • Round atelectasis • Intrapulmonary Sequestration • Hydatid disease Extrapulmonary • Fibrous tumor of the pleura • Loculated pleural effusion • Torsed pulmonary lobe • Chest wall tumors (Askin tumor) • AAA • Mediastinal masses |
5 pulmonary (TRASH), 6 extrapulmonary (AMFLAT)
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PULMONARY CYSTS
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Pneumatocele
Bulla/Bleb Cystic bronchiectasis Congenital cysts (Bronchogenic or CCAM) Hydatid cyst |
PBCCH
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PULMONARY CAVITY
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Abscess
Cavitated tumor Cavitated granulomatous mass Cavitated posttraumatic hematoma |
GATH
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PULMONARY ABSCESS
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Staphylococcus > Klebsiella > Streptococcus
AIDS: Nocardia, Legionella |
3 regular, 2 AIDS
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SMALL CYSTIC LUNG DISEASE
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True cyst wall
• Eosinophilic granuloma • Lymphangioleiomyomatosis • Cystic form of PCP • Honeycombing in any end-stage interstitial disease No cyst wall • Emphysema |
Four with walls (ELPH), one without walls
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thickening of interlobular septa
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Pulmonary edema
Venous obstruction Congenital pulmonary lymphangiectasia interstitial pneumonia (TB, viral, PCP, fungal) IPF drugs Sarcoid Collagen Vascular dz Lymphangitic tumor spread Pneumoconiosis EG |
PVC LID SCaLPE
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Upper lobe interstitial dz
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Cystic fibrosis (not an interstitial disease)
Ankylosing spondylitis Silicosis Sarcoid Eosinophilic granuloma (sparing of costophrenic angles) Tuberculosis Pneumocystis carinii |
CASSET Pcp
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Lower lobe interstitial dz
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Bronchiectasis (not an interstitial disease)
Aspiration Drugs, DIP Asbestosis Scleroderma, other collagen vascular diseases |
BADAS
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Acute interstitial dz
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Hypersensitivity (allergic alveolitis)
Edema Lymphoproliferative Pneumonitis, viral |
HELP
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Chronic interstitial dz
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Lymphangitic spread
Inflammation, infection Fibrosis Edema |
LIFE
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interstitial dz with increased lung volumes
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Cystic fibrosis (associated with this pattern but not
an interstitial disease) Eosinophilic granuloma (pneumothorax, 20%) Lymphangioleiomyomatosis (pneumothorax) |
CEL
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interstitial dz with decreased lung volumes
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Idiopathic pulmonary fibrosis
Scleroderma |
IS
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interstitial dz with pleural plaques
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asbestosis
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1
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interstitial dz with pleural effusion
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CHF
Lymphangitic carcinomatosis Rheumatoid disease |
CLR
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interstitial dz with enlarged lymph nodes
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Malignant adenopathy
TB fungus Sarcoid |
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interstitial dz with calcified lymph nodes
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Silicosis
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1
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GROUND GLASS OPACITY - lungs
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Interstitial diseases
BOOP Eosinophilic pneumonia Edema PCP DIP IPF, Active Viral Allergic hypersensitivity |
I BEEP DIVA
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RETICULONODULAR OPACITIES
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Edema
Pneumonia Lymphangitic tumor spread Fibrosis |
EPLF
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NODULAR OPACITIES
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Sarcoid/Silicosis
Pneumoconiosis EG CWP Hematogenous infection Hematogenous metastases |
SSPEeCHH
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CRAZY PAVING APPEARANCE
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• Pulmonary alveolar proteinosis
• ARDS • PCP • Lipoid pneumonia |
PAPL
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HALO PATTERN OF GROUND GLASS
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Early invasive aspergillosis
Hemorrhage around a neoplasm Post biopsy pseudonodule |
3
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PERIPHERAL GROUND GLASS OPACITY AND CONSOLIDATION
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• BOOP
• Infarcts • Septic Emboli • Collagen vascular disease • Contusion • DIP • Drug toxicity • Eosinophilic pneumonia • Fibrosis • Sarcoidosis |
BISCCDDEFS
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HONEYCOMBING PATTERN
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• UIP (idiopathic pulmonary fibrosis)
• Scleroderma/RA • EG • Drug toxicity: bleomycin • Silicosis • Asbestosis • Sarcoidosis • Hypersensitivity pneumonitis |
USED SASH
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DISEASES SPREADING ALONG BRONCHOVASCULAR BUNDLE
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• Sarcoidosis
• Lymphoma • Lymphangitic spread of tumor • TB • Kaposi's sarcoma |
SaLT LaKe
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TREE IN BUD APPEARANCE
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Infection
• TB • Bronchopneumonia • Fungal • Asian panbronchiolitis • Viral pneumonias Bronchial disease • Bronchiolitis Congential disoders • Cystic fibrosis • Dyskinetic cilia syndrome Other • Allergic bronchopulmonary aspergillosis • Lymphangitic carcinomatosis • EG |
TB FAV BCD ALE
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HYPERLUCENT LUNG
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Air trapping (plug, bronchiolitis, emphysema)
Congenital (hypogenetic lung) Oligemia (PE, PA stenosis) Chest wall abnormalities (mastectomy, Poland's) PTX |
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SMALL LUNG
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• Hypogenetic lung syndrome
• Agenesis of pulmonary artery • Chronic atelectasis • Bronchiolitis obliterans (Swyer-James syndrome) |
BACH.
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ENDOBRONCHIAL LESIONS
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Tumor: SqCC, Adenoid cystic CA, Mucoepidermoid CA, Small cell CA, Carcinoid, Mets, hamartoma
TB mucous plug FB trauma Broncholith |
seven tumors, five others
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Increased tracheal diameter
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tracheobronchomegaly (mounier-kuhn)
pulmonary fibrosis tracheomalacia |
3
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Decreased tracheal diameter
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• Saber-sheath trachea (most common cause)
• Tracheopathia osteochondroplastica • Tracheomalacia (decreased diameter on expiration) • Relapsing polychondritis • Amyloidosis • Sarcoidosis • Wegener's disease • Tuberculous and fungal stenosis |
STTaR SWAT
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Postinfectious bronchiectasis
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Childhood infection
Recurrent aspiration ABPA: central bronchiectasis Chronic granulomatous infection Pertussis |
CRAP G
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Other causes of bronchiectasis
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Bronchial obstruction
Cystic fibrosis (abnormal secretions) Bronchial cartilage deficiency: Williams-Campbell syndrome Abnormal mucociliary transport: Kartagener's syndrome |
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UPPER LOBE BRONCHIECTASIS
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• Cystic fibrosis
• TB • Radiation • ABPA (most commonly central) |
TRAC
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MUCOID (BRONCHIAL) IMPACTION
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Asthma
Cystic fibrosis ABPA Congenital bronchial atresia |
CACA
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PLEURAL-BASED MASS
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Mesothelioma
Fibrous tumor of the pleura Malignant thymoma Lymphoma Metastases(breast, lung, prostate, thyroid, renal) Lipoma Rib tumors Neurofibromas TB Asbestos Actinomycosis Trauma |
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Rib tumors in children
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EG, ABC, Ewing's sarcoma, neuroblastoma
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EAEN
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Rib tumors in adults
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metastases > multiple myeloma > Paget's disease, fibrous
dysplasia |
4
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CALCIFIED PLEURAL PLAQUES
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• TB
• Asbestos • Fluid (empyema, hematoma) • Talc |
TAFT
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ELEVATED HEMIDIAPHRAGM
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Phrenic nerve paralysis
Immobility due to pain Abdominal Mass lesions Diaphragmatic hernia Subpulmonic effusion (apparent elevation of hemidiaphragm) |
5
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ANTERIOR MEDIASTINAL MASSES
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Thymoma
Thyroid T-cell lymphoma Teratoma/germ cell tumor |
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SUPERIOR MEDIASTINAL MASS
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Thyroid masses
Adenopathy/Lymphoma Lymphatic cysts, cystic hygroma Small Cell CA Vascular Aneurysm |
5
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MIDDLE MEDIASTINAL MASS
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Lymphadenopathy
Congenital cysts Aneurysm Esophagus |
LACE
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Low-attenuation lymph nodes
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• TB and fungal infections in AIDS (ring enhancement)
• Necrotic metastases (aggressive neoplasm) • Lymphoma (occasionally) |
3
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Vascularized lymph nodes
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• Castleman's disease (giant benign nodal hyperplasia)
• Vascular mets |
2
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Vascular mets
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renal cell
thyroid small cell melanoma |
4
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Calcified lymph nodes
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• TB
• Histoplasmosis, other fungus • Radiation therapy • Sarcoidosis • Silicosis |
THRuSSh
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POSTERIOR MEDIASTINAL MASS
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Neurogenic, 90% (schwannoma
and neurofibroma) Extramedullary hematopoiesis T-spine neoplasm/infxn/hematoma Aneurysm Azygos continuation |
5
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CARDIOPHRENIC ANGLE MASS
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Fat pad (most common cause)
Diaphragmatic hernia (Morgagni or Bochdalek) Pericardial cyst Cardiophrenic angle nodes (lymphoma usually recurrent, s/p radiation) Aneurysm Dilated right atrium Anterior mediastinal mass Primary lung or pleural mass |
8
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HIGH-DENSITY MEDIASTINAL LESIONS (NONCONTRAST CT)
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Calcified lymph nodes
Calcified primary mass (Tumor, Goiter, Aneurysm) Hemorrhage |
3
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DENSELY ENHANCING MEDIASTINAL MASS
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Aneurysm
Esophageal varices Hypervascular tumors (paraganglioma or mets) Goiter Castleman's disease |
H CAGE
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PROMINENT HILA
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Tumor, adenopathy, PA enlargement
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EGGSHELL CALCIFICATION IN HILAR NODES
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• Silicosis, CWP
• Treated lymphoma • Granulomatous disease (rarely) • Sarcoid (rare and late in disease ) |
4
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PNEUMOMEDIASTINUM
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interstitial emphysema
pneumothorax bronchial laceration boerhaave's post-op from abdomen (bowel perf or post-op) mediastinitis |
7
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