Chest Radiology DDX

Question 1

Anterior Mediastinal Masses

Answer 1

Thymoma
Teratoma
Substernal thyroid
Lymphoma

Question 2

Opacified Hemithorax

Answer 2

Atelectasis
Pleural Effusion
Pneumonia
Post-pneumonectomy

Question 3

Pneumomediastinum

Answer 3

Ruptured esophagus 
Ruptured trachea/bronchus
Iatrogenic 
Asthma
Pneumoperitoneum

Question 4

Chronic Alveolar Disease

Answer 4

Alveolar cell cancer
Alveolar sarcoid
Lymphoma
Alveolar proteinosis

Question 5

Large Cavitary Lung Lesion

Answer 5

Abscess
Carcinoma
TB

Question 6

Bi basilar Interstitial Disease

Answer 6

BADASS

Bronchiectasis
Aspiration
DIP
Asbestosis
Sickle Cell Disease
Scleroderma

Question 7

Upper Lobe Disease

Answer 7

TB (secondary TB)
Silicosis
Eosinophilic granuloma
Ankylosing spondylitis

Question 8

Micronodular Lung Disease

Answer 8

Mets
Sarcoid
Pneumoconiosis
Miliary TB

Question 9

Chronic Interstitial Disease

Pulmonary Fibrosis

Answer 9

PIGNIC

Pneumoconiosis 
Interstitial Pneumonia
Granulomatous disease
Neoplastic disease
IPF
Collagen Vascular disease

Question 10

Small Cavitary Lung Lesions

Answer 10

Septic emboli
Rheumatoid nodules
Squamous or transitional cell mets
Wegener’s

Question 11

Lymphangitic spread to lungs

Answer 11

Lung
Breast
Gastric
Pancreas
Laryngeal
Cervical

Question 12

Multiple Lung Nodules

Answer 12

Mets
Wegener's 
RA nodules 
AVMs
Septic emboli

Question 13

Pulmonary interstitial edema

Answer 13

Heart failure
Lymphangitic spread
Allergic reaction

Question 14

Shifting infiltrates

Answer 14

Loeffler's syndrome
ABPA
Asthma
Polyarteritis
Viral pneumonia

Question 15

Unilateral hyperlucent lung

Answer 15

Sweyer-James syndrome
Pulmonary embolism
Pneumothorax
Obstructive emphysema

Question 16

Rapidly clearing alveolar infiltrate

Answer 16

Hemorrhage
PE
Aspiration
Pneumococcal pneumonia

Question 17

Cavitary pneumonia

Answer 17

Staph
Strep
TB
Gram negative (klebsiella)

Question 18

Middle mediastinal masses

Answer 18

Lymphadenopathy
Aneurysms
Esophageal duplication
Bronchogenic cysts

Question 19

Masses with air bronchograms

Answer 19

Lymphoma
Alveolar ca
Pseudolymphoma (maltoma)

Question 20

Hilar adenopathy

Answer 20

Sarcoid
TB 
Lymphoma
Bronchogenic ca
Mets

Question 21

Cavities containing masses

Answer 21

Aspergillosis
Cavitating bronchogenic ca
Tuberculosis
Hydatid cyst

Question 22

Infiltrates with effusions

Answer 22

Staph pna
Strep pna
TB
Pulmonary infarct

Question 23

“Mass” + ipsilateral adenopathy

Answer 23

Bronchogenic ca
Lymphoma
TB

Question 24

Solitary pulmonary nodule

Answer 24

Bronchogenic ca
Hamartoma
Histoplasmosis 
TB granuloma
Bronchial adenoma
Solitary met
Round pnuemonia
Rounded Atelectasis

Question 25

Pleural effusion

Answer 25

``` Had Mets Pancreatitis Trauma Empyema Collagen vascular dz Ovarian tumor (Meig's) Chylothorax ```

Question 26

Left-sided pleural effusion

Answer 26

Boerhaaves Dissecting aortic aneurysm Pancreatitis Distal thoracic duct rupture

Question 27

Multiple small calcifications

Answer 27

``` Histoplasmosis Silicosis Chicken pox pneumonia Pulmonary ossification from MS Alveolar microlithiasis ```

Question 28

Posterior mediastinal masses

Answer 28

Neurogenic tumors Lymphadenopathy Extra medullary hematopoiesis

Question 29

Mediastinal adenopathy

Answer 29

``` Bronchogenic ca Lymphoma TB Mets Sarcoid ```

Question 30

Lung Dz and rib destruction

Answer 30

Bronchogenic ca, i.e. Pancoast tumor Actinomycosis Blastomycosis Multiple myeloma

Question 31

Pleural calcification

Answer 31

Old TB empyema Asbestosis exposure Hemothorax

Question 32

"Masses" in cardiophrenic angle

Answer 32

Sequestration Diaphragmatic hernia Pericardial cyst

Question 33

Unilateral pulmonary edema

Answer 33

Aspiration Disease in other lung, e.g. COOD Postural Rapid expansion of PTX

Question 34

Reverse "pulmonary edema"

Answer 34

Eosinophilic lung disease, e.g. Loeffler's Sarcoid Pulmonary contusions

Question 35

Acute Alveolar Infiltrate

Answer 35

``` Pulmonary Edema Pneumonia Aspiration Hemorrhage (Blood, pus, water) ```