Imaging

Question 1

What are the causes of diffuse airspace disease?

Answer 1

Blood
Pus
Water
Cells (malignancy, Eosinophilic PNA, OP)
Other (PAP, Lipoid PNA

Question 2

What are the causes of Linear or septal opacifications?

Answer 2

Pulmonary edema
Lymphangitic Carcinomatosis
Chronic or Recurrent pulmonary Hemorrhage
Pulmonary fibrosis

Question 3

What are the causes of reticular patterns?

Answer 3

UIP
NSIP
ARDS
Cystic lung disease (PLCH, LAM, LIP, Birt-Hogg-Dube, cystic bronchiectasis)

Question 4

What are the causes of nodular patterns?

Answer 4

NICO

Neoplastic
- Malignant - Bronchogenic carcinoma, Metastasis (thyroid, melanoma) Lymphoma, Carcinoid

Inflammatory

• infectious - TB, NTM, Fungal, viral (vzv)
• Granuloma - TB, NTM, Fungal infection, Sarcoid, ANCA, HP, Pneumoconiosis
• Lung abscess
• Rheumatoid nodule

Congenital

• AV malformation
• Lung cyst

Other

• Mucoid impaction
• Intrapulmonary LN
• Amyloidosis

Question 5

What are the causes of a Solitary pulmonary nodule?

Answer 5

Malignancy (lung carcinoma, lymphoma, metastatic disease, sarcoma)
Infection (Aspergillosis, PNA, Granulomatous infection - TB MAC, cryto, histo, coccidiodies, lung abscess)
Inflammatory (EGPA, GPA, RA, Sarcoid)
Idiopathic/Misc (rounded atelectasis, amyloid)
Vascular lesion (infarct, septic emboli, pulmonary artery aneurysm, pulmonary vein varix)
Airways (mucoid impaction, lipoid pneumonia)
Congenital (AV fistula, bronchogenic cyst, intrapulmonary LN)

Question 6

What are the causes of a Chronic Consolidation?

Answer 6

TBBAALLLS
TB
BOOP (OP)
BAC (Bronchoalveolar carcinoma)
Alveolar proteinosis
ANCA
Lipoid PNA
Lymphoma
LIP
Sarcoidosis

SPACE-V
Sarcoidosis
Pneumonia (TB/Atypical, Organizing, Lipoid)
Atelectasis (rounded)/ Alveolar proteinosis
Cancer (adeno/lymphoma)
Eosinophilic pneumonia
Vasculitis

Question 7

What are the causes of Crazy Paving?

Answer 7

Acute lung injury (ARDS/AIP_
Edema
Infection (Viral, PJP)
OP
Hemorrhage
PAP
Lipoid PNA
Drug/Radiation
Eosinophilic PNA

Question 8

What are the causes of Upper lobe ILD?

Answer 8

HASTEN

HP
Ank Spond
Sarcoidosis/Silicosis
TB
EGPA
Neurofibroma

Question 9

What are the causes of Lower lobe ILD?

Answer 9

BAD RASH

Bleomycin
Amiodarone
Drugs
RA
Asbestosis
Scleroderma
Hamman-Rich Syndrome

Question 10

What are the Eosinophilic lung diseases?

Answer 10

Idiopathic (Simple pulmonary eosinophilia or Loftlers syndrome, Acute and Chronic eosinophilic pneumonia, Idiopathic hypereosinophilic syndrome)

Eosinophilc Lung Disease with Angitiis (EGPA, GPA, PAN, Collagen vascular disease)

Eosinophilic Lung Disease with a known cause (Drugs, parasitic infection, fungi, bronchocentric granulomatosis)

Question 11

What are the causes of peripheral GGO?

Answer 11

COP
Chronic eosinophilic PNA
Acute eosinophilic PNA

Question 12

What are the causes of a necrotizing pneumonia?

Answer 12

Typicals/Atypicals (Strep, staph, klebsiella)

Mycobacterium (TB, MAC)

Nocardia

Histo, Crypto, Blasto

Question 13

What are the causes of Fibrotic Lung disease?

Answer 13

UIP
Fibrotic NSIP
Fibrotic HP
Sarcoidosis

Question 14

What are the categories of Cystic lung disease?

Answer 14

Primary and acquired

Question 15

What are Primary Cystic Lung diseases?

Answer 15

Cysts are a primary features
PLCH
LAM
LIP
DIP
Birt-Hogg-Dube
Sjogrens

Question 16

What are the Acquired Cystic Lung diseases?

Answer 16

Cysts are a secondary feature of a primary disease
UIP
PJP
Sarcoidosis
Light Chain Deposition Disease
Amyloidosis

Question 17

What are the 3 types of bronchiectasis?

Answer 17

Cylindrical (50%) - Signet ring sign, tram tracking
Cystic (40%) - “Bunch of grapes” appearance. Saccular dilation of bronchi that extend to the pleural surface.
Varicose (10%) - Intermittent dilated and narrowing of airway

May have multiple types (25%)

Question 18

What are the etiologies of bronchiectasis?

Answer 18

Idiopathic
Post-infectious (bacterial PNA, TB, MAC)
Autoimmune/CTD
ABPA
CF
Primary ciliary dyskinesia
Humoral immunodeficiency (low immunoglobulins)
Aspiration
Alpha 1 AT deficiency

Question 19

What are risk factors for Primary spontaneous PTX?

Answer 19

Smoking
Family history
Marfans
Thoracic endometriosis

Question 20

What are the risk factors for Secondary spontaneous PTX?

Answer 20

COPD
TB
CF
PCP

Question 21

What is the differential for hemoptysis?

Answer 21

Infection/airways - Bronchitis, TB, bronchiectasis, aspergilloma

Malignancy - Carcinoid, NSCLC, SCLC

CTD - anti GBM, GPA, SLE

Drugs - Cocaine, A/C

Vascular - AVM, Bronchial artery aneurysm, PE

Question 22

What are the characteristics of airspace disease?

Answer 22

Fluffy opacification without clear margins
Air bronchograms
Silhouette sign

Question 23

What are the 7 patterns on CT Chest?

Answer 23

Honeycomb
Cystic
Nodular
Ground glass
Mosaic 
Tree-in-bud
Septal thickening

Question 24

What are the causes of Honeycombing?

Answer 24

IPF
Asbestosis
CTD
Drugs

If upper lobe - Fibrotic HP, Sarcoidosis, Pneumoconiosis

Question 25

What are the causes of Cystic disease?

Answer 25

PLCH - In smokers, upper lobe predominant, has bizarre cysts with thicker walls as well as nodules. LAM - Normal round cyst, normal parenchyma, upper, mid and lower lung zones, young women. Often chylous effusions. LIP - Lower lung predominant CTD PCP - Diffuse ground glass, irregular cysts (actually expanding pneumatoceles), vary in size, number and wall thickness, often multiloculated Emphysema (look-alike)

Question 26

How do you differentiate emphysema from cysts?

Answer 26

Emphysema has no full wall and central dot

Question 27

What are the 4 patterns of nodularity on CT?

Answer 27

Perilymphatic Random Centrilobular Bronchovascular

Question 28

What is the perilymphatic pattern?

Answer 28

Nodules with preference for pleura, fissures and bronchovascular bundle

Question 29

What are the causes of perilymphatic distribution?

Answer 29

Sarcoidosis

Question 30

What are the causes for random nodules?

Answer 30

Silicosis, coal workers pneumoconiosis TB/Fungal Metastasis - colon, melanoma

Question 31

What are the causes for centrilobular nodularity?

Answer 31

Tend to be less dense HP Bronchiolitis

Question 32

What are the causes for bronchovascular nodularity

Answer 32

``` Lymphoproliferative disorders Lymphangitic carcinomatosis Sarcoidosis Organizing pneumonia Infectious pneumonia ```

Question 33

What are the causes of Ground Glass?

Answer 33

``` Pus - viral, atypical, PJP Blood - Hemorrhage Cells - Adenocarcinoma Water - Edema Other - OP, PAP, NSIP, DIP ```

Question 34

What are the causes of Mosaic Pattern?

Answer 34

Infiltration disease (multifocal pneumonia, though other causes of GGO are possible) Small airways disease (asthma, HP, Bronchiolitis) Pulmonary vascular disease

Question 35

What causes Tree-in-Bud pattern?

Answer 35

Infection (TB, MAC, Bacterial) ABPA (finge in glove) CF Aspiration Bronchiolitis

Question 36

What are the causes of interlobular septal thickening?

Answer 36

Smooth - Edema/infectious/Sarcoidosis Nodular - Lymphangitic carcinomatosis/sarcoidosis