Post on 09-Feb-2016
description
Dr Ahmed Refaey , FRCR
Differential diagnosis of chest diseases
Micronodular(miliary)disease
TB Histoplasmosis Chicken box Sarcoidosis LCH Pneumoconiosis Alveolar microlithiasis Metastasis
Septal thickening
Beaded / nodular * lymphangitic carcinomatosa * sarcoidosis * silicosis
Smooth * lymphangitisc carcinomatosis * pulmonary edema * alveolar proteinosis
Bilateral perihilar air-space disease
Pulmonary edema Pulmonary hemorrhage Alveolar proteinosis PCP
Acute alveolar infiltrate
Pulmonary edema Pneumonia Pulmonary hemorrhage Aspiration
Chronic alveolar disease
Alveolar cell carcinoma Alveolar sarcoidosis Lymphoma Alveolar proteinosis
Unilateral hyperlucent lung Obstructive emphysema Mcleoid syndrome ( Swyer James
syndrome) Pneumothorax Pulmonary embolism Bullous disease Air trapping e.g. FB , mass Poland syndrome
Multiple lung nodules (macronodules)
Metastasis Wegner’s granulomatosis Rheumatoid n nodules AVMs Septic emboli
Small cavitating lung lesions Septic emboli Rheumatoid nodules Wegner’s granulomatosis Sq. or transitional cell ca metastasis
Upper lober disease( CASSET P ) Cystic fibrosis Ankylosing spondylitis Sarcoidosis Silicosis Esinophilic granuloma PCP
Basilar interstitial lung disease ( BADASS )
Bronchiectasis Aspiration Drugs / DIP-UIP Asbestosis Sickle cell disease Scleroderma
Masses with air bronchogram Lymphoma Alveolar cell carcinoma Pseudolymphoma ( maltoma )
Anterior mediastinal mass
Thymic tumors Substernal Thyroid LNs Germ cell tumor
Middle mediastinal mass
LNs Aneurysm Esophageal duplication Bronchogenic cyst
Posterior mediastinal mass Neurogenic tumors Paraspinal hematoma Paraspinal abscess Extraskeletal hematopoiesis LNs enlargement Lateral meningeocele
Opacified hemithorax
Atelectasis Pneumonia Pleural effusion Post pneumonectomy
Pneumomediastinum
Ruptured esophagus Ruptured trachea / bronchus Iatrogenic Broncheal asthma pneumoperitoneum
Pleural calcification
Old TB empyema Asbestos exposure Hemithorax
Cardiopherenic angle mass
Pericardial cyst Diaphragmatic hernia ( Morgagni ) Lung sequestration Pericardial fat bad
Unilateral pulmonary edema Aspiration Disease in other lung e.g. COPD Postural Rapid expansion pulmonary edema “ Look for ICT”
Long segment tracheal narrowing
Tracheopathia osteoplastica Tracheo-broncheal amyloidosis Wegner’s granulomatosis Intubation injury Tracheobronchomalacia Relapsing polychondritis Papillomatosis ( extensive )
Peripheral distributed lung disease
Esinophilic pneumonia --- upper lobes
BOOP ----- lower lobes Hypersensitivity pneumonitis Multiple infarcts DIP Alveolar cell carcinoma
Bronchiectasis
CT criteria of bronchiectasis
1- lack of tapering of bronchi2-internal diameter of bronchus larger
than the adjacent artery3- bronchi are visible within 1 cm of
pleura4- mucus-filled , dilated bronchi
Bronchiectasis
Chronic airway infection Pulmonary fibrosis –traction bronchiectasis ABPA ------- central bronchiectasis Cystic fibrosis ------- apical bronchiectasis Mounier-Kuhn syndrome –
tracheobronchomegally Kartagner syndrome --- situs inversus +
sinusitis
Mounier-Kuhn syndrome
ABPA
Cystic fibrosis
Kartagener’s syndrome
Dilated esophagus
Scleroderma Achalasia Obstructing tumor Drugs ( atropine) Surgury ( gastric pull-up)