Flashcards in Radiology Correlations Deck (32)
What pattern does bronchopneumonia show on a CT scan?
Tree in bud (bloom) pattern; usually multilobar
Lobar pneumonia will typically present with what on CXR?
consolidation which is typically associated with alveolar fluid/exudate
What is the bulging fissure sign?
ex. Klebsiella PNA expanding the lung lobe so much it bulges beyond its normal size
Abscesses will usually have what on CXR?
air fluid level within the cystic space
Which organisms are more likely to cause an abscess in lobar pneumonia?
Klebsiella, Staph aureus and anaerobes
What pathology can lead to widening of airways with extension into the peripheral lung fields on CXR?
What are the DDX for bronchiectasis?
Cystic fibrosis, allergic bronchopulmonary aspergillosis (ABPA), chronic infections (Tb), primary ciliary dyskinesia, Young's syndrome
Situs inverses with dextrocardia may be seen in a subset with pts with what?
primary ciliary dyskinesia (Kartagener syndrome)
What causes bat wing infiltrates?
pulmonary edema (central pattern of lung involvement), hypersensitivity pneumonitis, inhalation injury; anything favoring proximal vascular or airway involvement
What can cause reverse bat wing infiltrates?
Fibrosis (ex. IPF, sarcoidosis, other ILD with fibrosis); anything favoring peripheral lung involvement
Hypersensitivity pneumonitis follows the airways, but sarcoidosis follows what?
lymphatics (increased pleural involvement)
What can cause bilateral white out (diffuse lung involvement) on CXR?
ARDS (MC), severe pneumonia, severe atelectasis, diffuse hemorrhage, malignancy (rare)
What makes pulmonary nodules white on CT images?
What are the different patterns of calcification?
Diffuse (associated with benign lesions), central, popcorn, laminate, stippled, eccentric
What pattern of calcification is associated with histoplasmosis (old granulomas)?
What pattern of calcification is seen with hamartomas?
What are some tumor characteristics that would be worrisome for malignancy?
Bigger size is worse, rate of growth (will it become bigger? has it become bigger?), more solid = more worrisome, more irregular border = more worrisome, calcification is more often present with benign tumors
What are some pt characteristics that are concerning for malignancy?
Age of pt (younger than 35 much less likely to be cancer), cigarette smokers much more likely to have malignancy, if there is a prior hx of cancer there is a likelihood for the lesion representing metastasis, FHx of lung cancer
What are the Fleischner guidelines?
Looks at age, smoker status, size, growing, solid, calcified
What factors would suggest that a biopsy is needed?
Increased age, is a smoker, nodule increased in size, nodule is growing, nodule is solid and is not calcified
What is atypical about mucinous adenocarcinoma and adenocarcinoma in situ?
can look like pneumonia and can be bilateral
What can cause ground glass opacities?
infections, ILD, edema, hemorrhage, neoplasia (such as adenocarcinoma in situ)
Airways can dilate within solid tumors causing what?
Bubble lucencies which is concerning for invasive tumor
What phenomena can occur with squamous carcinoma?
What can cause wedge shaped infiltrates on CXR?
resorption atelectasis (infarcts can also be wedge shaped on CT scan)
What can cause resorption atelectasis?
a tumor leading to obstruction (ex. endobronchial squamous carcinoma or endobronchial carcinoid tumor)
Squamous carcinoma often occurs centrally due to what?
Its association with damaged airway epithelium
In a primary pneumothorax the pleural cavity pressure is what?
Less than the atm pressure
In a tension PTX the pleural cavity pressure is what?
Greater than the atm pressure
What is a primary PTX?
typically due to a limited introduction of air into the thoracic space; most often due to primary lung pathology
What is a tension PTX?
One way unchecked accumulation of air; most often due to chest wall penetration/trauma; mass effect with midline shift