The 1578 Chest Conference/ 3 Biennial Clinical...
Transcript of The 1578 Chest Conference/ 3 Biennial Clinical...
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The 1578th Chest Conference/ 3rd Biennial Clinical-
Radiologic-Pathologic Correlation
Radiologic-pathologic correlation of pulmonary
diseases
Harumi Itoh, M.D.
University of Fukui, Japan
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Interlobular septum
Br
PA
PV
PV
Centriacinar emphysema ①
PV
Br
PA
ILS
Centrilobular normal lung
Paraseptal normal lung
Centriacinar emphysema ② Centriacinar emphysema
Paraseptal normal lung with polygonal shape
③
Bronchopneumonia
Cavity
Multiple nodules
④ Bronchopneumonia (centrilobular nodule)
MB
1 mm
Respiratory bronchiole
⑤ R
Pulmonary tuberculosis
Small nodules
⑥
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Br
PV
ILS 3 mm
Centrilobular cavity
Bronchiole
Pulmonary tuberculosis (centrilobular loose nodules) ⑦ Pulmonary tuberculosis ⑧
2 mm
Br
Br
Pulmonary tuberculosis (centrilobular compact nodules) ⑨
10
10 mm
PV
Pulmonary tuberculosis (centrilobular nodules) ⑩ Pulmonary tuberculosis (centrilobular nodules) ⑪
slice3 . . . . 3 mm
Pulmonary tuberculosis (tree in bud) ⑫
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Pulmonary tuberculosis (tree in bud) ⑬
5mm
Silicosis (centrilobular nodules) Interlobular septum ⑭
3mm
Silicosis (centrilobular compact nodule)
Br
PA
⑮
1mm
Br PA
PA
Silicosis (centrilobular small nodule) ⑯ Silicosis (paraseptal nodule)
5mm PV
Centrilobular nodule
⑰
1mm
Silicosis (paraseptal nodule) ⑱
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Silicosis
Left upper lobe
⑲
5mm
Centrilobular
Paraseptal
Interlobular septum
Pleura
Silicosis Calcified nodules
⑳
1mm
Silicosis (centrilobular nodule)
Interlobular septum
Centrilobular nodule
PV
Bronchiole Focal emphysema
21
Silicosis (centrilobular + paraseptal nodules) 22
5 mm
Langerhans cell histiocytosis 23 Langerhans cell histiocytosis
Centrilobular nodules
Centrilobular cysts
24
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PV
RB
PV
PV
PV
MB PA
Perilobular, periacinar fibrosis (fibrosis of alveoli along pulmonary venules)
IPF/UIP Courtesy of Dr. T. Takemura, Japan 25
485
IPF/UIP
Subpleural small opacities
Courtesy of Dr. T. Ogura, Japan
26
PA
RB PV
ILS PA
PA
PV
PV
PV
0.5mm
Courtesy by Dr. T. Takemura, Japan 1 mm
*
f-NSIP 27
N
⑧ ⑨ ⑩
R SSc Polygonal opacities
Traction bronchiectasis
Courtesy by Dr. T. Ogura, Japan
28 IPF/UIP (honeycomb lung)
2 cm 2 cm
29
10mm
Courtesy by Dr. T. Takemura, Japan
Honeycomb lung (IPF/UIP)
10mm
PV
PV
PV
PV
PV
MB
ILS
2mm PA
PA
30
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Honeycomb lung(IPF/UIP) 31
160 182
* *
Pulmonary fibrosis combined with emphysema Courtesy of Dr. T. Ogura, Japan 32
4 years later 0
Cystic change with destruction of respiratory bronchioles and alveoli
V
A
* *
V
A
A
PA in emphysematous
space
Perilobular fibrosis along
PV and pleura
MB
Courtesy of Dr. T. Takemura
Pulmonary fibrosis combined
with emphysema 33
Pulmonary edema (left heart failure)
Short septal lines
34
3cm
Pulmonary edema
Short s
epta
l lines in
lung b
ase
35
1cm
thickened interlobular septum
and pleura
Pulmonary edema 36
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Centilobular nodules Pulmonary ossification
3mm 3mm
ILS
ILS
37 Thickened long septa
Left upper lobe
Coronal CT
Normal long septa 38
Thickened bronchoarterial bundle
PV
Thickened pleura
Thickened interlobular septum
Lymphangiosis carcinomatosa 39
Thickened bronchovascular
bundles (central and periphery)
Lymphangiosis
carcinomatosa 40 Lymphangiosis carcinomatosa 41 Lymphangiosis carcinomatosa
2mm
Thickened bronchoarterial bundle
Thickened interlobular septum
42
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Lymphoproliferative disorder
Bronchovascular bundle
Bronchovascular bundle
43
Y.S
Lymphoproliferative disorder
Thickening of centrilobular
bronchovascular bundles
48
44
③ ④
Pulmonary sarcoidosis 45
Pulmonary sarcoidosis
PV
Br・PA
Br・PA
46 Pulmonary sarcoidosis
Br
PA
47 Pulmonary sarcoidosis
2mm
48
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RB
Pulmonary sarcoidosis 49 Pulmonary sarcoidosis 50
K.N
Pulmonary thromboembolism 51
②
Pulmonary thromboembolism
Pulmonary arteries
52 Metastasis of hepatic cancer 53
5 mm Pulmonary vein
Bronchiole
Metastasis of hepatic cancer
Pulmonary artery
54
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1 mm
Bronchiole
Pulmonary artery: dilated with tumors
Metastasis of hepatic cancer 55
① ②
Cystic metastasis of bladder cancer
Courtesy of Dr. S. Imokawa Thickened blood vessels
56
1mm
Pulmonary artery: filled by tumor and thrombus
Perivascular tumor
Metastasis of bladder cancer
Courtesy of Dr. S. Imokawa 66
57
Org. DAD
Ground glass shadow
Traction bronchiectsis
58
1 mm
Org. DAD
AD
AD
Thickened back to back alveoli
59
K.T
Adenocarcinoma
Thickened back to back alveoli intervened by contrasted air space
60
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Thickened back-to-back alveoli
Normal back-to-back alveoli
GGA
Adenocarcinoma with lepidic growth Adenocarcinoma 61