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chest integrated “lp5”

 

image number image 2 Title

CT Emphysema, Paraseptal Emphysematous Changes Bilateral Lower Lobes
65-year-old male with emphysema of the lungs presents with a cough, fever and leukocytosis. CT in the axial plane shows bibasilar paraseptal emphysematous changes and centrilobular changes in the lingula and RUL. Hyperinflation with resultant small heart is noted.
Ashley Davidoff MD TheCommonVein.net 259Lu 117504

 

 bleb

Axial CT – Lady Windermere Syndrome
61-year-old male with a history of treated mycobacterial infections including MAC and chronic cough.
Axial CT at the level of the mid to lower chest shows mildly ectatic segmental airways to the lower, and middle lobe bronchi but significant bronchiectasis to the middle lobe and lingula involving the subsegmental airways. There is a relative paucity of mucus in the ectatic airways. The history of MAC and the distribution of the bronchiectasis in the middle lobe and lingula are reminiscent of the diagnosis of Lady Windermere syndrome
Ashley Davidoff MD TheCommonVein.net 250Lu 135876

  

Axial CT – Lady Windermere Syndrome
61-year-old male with a history of treated mycobacterial infections including MAC and chronic cough.
Axial CT at the level of the mid to lower chest shows mildly ectatic segmental airways to the lower, and middle lobe bronchi but significant bronchiectasis to the middle lobe and lingula involving the subsegmental airways. There is a relative paucity of mucus in the ectatic airways. The history of MAC and the distribution of the bronchiectasis in the middle lobe and lingula are reminiscent of the diagnosis of Lady Windermere syndrome
Ashley Davidoff MD TheCommonVein.net 250Lu 135876

 bronchiectasis
136598c

Fibrotic NSIP
59-year-old male presents with history of scleroderma, Raynaud’s disease, and ILD
Upper Image
Axial CT shows bibasilar ground glass, bronchiectasis, and bronchiolectasis with volume loss and with crowding of the bronchovascular bundles posteriorly. There is subpleural sparing. Note air-fluid level in the distended esophagus.
The lower image focuses on the peripheral sparing. The spared secondary lobules have also undergone enlargement secondary to the fibrotic process
Ashley Davidoff MD TheCommonVein.net 110Lu 136598c01

 136598c

Fibrotic NSIP
59-year-old male presents with history of scleroderma, Raynaud’s disease, and ILD
Upper Image
Axial CT shows bibasilar peripheral reticular changes, ground glass, bronchiectasis, and bronchiolectasis with volume and with crowding of the bronchovascular bundles posteriorly. There is subpleural sparing posteriorly. Note air-fluid level in the distended esophagus.
Lower Image
The lower image focuses on the traction bronchiectasis caused by the fibrotic process
Ashley Davidoff MD TheCommonVein.net 110Lu 136598c

 bronchiolectasis

Chest CT above shows bronchiolitis which is characterized by peribronchial  thickening which is thickening of the small airways of lung (yellow arrows)Ashley Davidoff MD TheCommonVein.net 81F-bronchiolitis-infection-inflammation-004
Chest CT above shows bronchiolitis which is characterized by peribronchial  thickening which is thickening of the small airways of lung (yellow arrows)Ashley Davidoff MD TheCommonVein.net 81F-bronchiolitis-infection-inflammation-004
 bronchiolitis
Frontal and Lateral CXR shows follicular bronchiolitis which is characterized by
 a coarsened nodular interstitial pattern. 
Ashley Davidoff MD TheCommonVein.net 132Lu 136650c B.A

 

Frontal and Lateral CXR shows follicular bronchiolitis which is characterized by
 a coarsened nodular interstitial pattern. 
Ashley Davidoff MD TheCommonVein.net 132Lu 136650c B.A

 bronchiolitis (CXR)
 

Finger in Glove Sign
19 year old female with cystic fibrosis and bronchiectasis
CT scan through the upper lung fields shows mucin filled subsegmental bronchi of the right upper lobe with morphology reminiscent of the “finger in glove” sign
Courtesy Priscilla Slanetz MD MPH TheCommonVein.net 31966 B.A

  

Finger in Glove Sign
19 year old female with cystic fibrosis and bronchiectasis
CT scan through the upper lung fields shows mucin filled subsegmental bronchi of the right upper lobe with morphology reminiscent of the “finger in glove” sign (point to by yellow arrows)
Courtesy Priscilla Slanetz MD MPH TheCommonVein.net31966cl B.A

 bronchocele
bronchocentric   bronchocentric


  CT in the axial plane shows a bilobed  calcified broncholith in the lateral segment of the middle lobe (c, d white arrowheads) with post obstructive atelectasis (c, blue arrowhead)
Ashley Davidoff MD TheCommonVein.net 136585cL B.A

 1

CT in the axial plane shows a bilobed calcified broncholith in the lateral segment of the middle lobe (c, d white arrowheads) with post obstructive atelectasis (c, blue arrowhead)
Ashley Davidoff MD TheCommonVein.net 136585cL B.A

 broncholith
 

CT Scan Bilateral Apical Builla Centrilobular Emphysema
CT scan in the axial plane  shows bilateral apical bullous lung disease, most commonly seen in emphysema 
Ashley Davidoff MD TheCommonVein.Net 136440 B.A

  

CT Scan Bilateral Apical Builla Centrilobular Emphysema
CT scan in the axial plane  shows bilateral apical bullous lung disease, most commonly seen in emphysema 
Ashley Davidoff MD TheCommonVein.Net 136440 B.A

 bulla

CT Scan Bilateral Apical Bulla Centrilobular Emphysema
CT scan in the coronal plane  shows bilateral apical bullous lung disease, magnified in the lower image
Ashley Davidoff MD TheCommonVein.Net 136439c B.A


CT scan in the coronal plane of  shows bilateral apical bullous lung disease, magnified in the lower image
Ashley Davidoff MD TheCommonVein.Net 136439c B.A

 bullous emphysema
 


Coronal and sagittal CT reconstructions show a cavitating mass in the superior segment of the right lower lobe (upper images) correlated with axial images (lower panel)
Ashley Davidoff MD TheCommonVein.net 176Lu 136737 B.A


Coronal and sagittal CT reconstructions show a cavitating mass in the superior segment of the right lower lobe (upper images) correlated with axial images (lower panel)
Ashley Davidoff MD TheCommonVein.net 176Lu 136737 B.A

 cavity (lungs)
132575.8bL

CT above shows a secondary lobule which is the smallest identifiable unit of the lung (made up of around 30 a0cni supplied by a common distal bronchiole and pulmonary artery)and its boundaries can be visualized by assessing the interlobular speta  (red arrows)Ashley Davidoff MD TheCommonVein.net B.A

 CT above shows a secondary lobule which is the smallest identifiable unit of the lung (made up of around 30 a0cni supplied by a common distal bronchiole and pulmonary artery)and its boundaries can be visualized by assessing the interlobular speta  (red arrows)Ashley Davidoff MD TheCommonVein.net B.A centrilobular (secondary lobule)
 

Centrilobular Emphysema in the Upper Lobes of the Lungs
Axial CT (a) with magnified view of the upper lobes of a 66year female with centrilobular emphysema shows an expanded lobule with a centrilobular vessel in the middle characteristic of centrilobular emphysema
Ashley Davidoff MD TheCommonvein.net RnD B.A

Centrilobular Emphysema in the Upper Lobes of the Lungs
Axial CT (a) with magnified view of the upper lobes of a 66year female with centrilobular emphysema shows an expanded lobule with a centrilobular vessel in the middle characteristic of centrilobular emphysema
Ashley Davidoff MD TheCommonvein.net RnD B.A

 centrilobular emphysema

Lingular Pneumonia
52 year old male presents with a cough and fever
CT scan in the axial plane shows a lingular consolidation with air bronchograms and a positive silhouette sign. Both the superior and inferior lingular segments are involved
Ashley Davidoff MD TheCommonVein.net135190 B.A

Lingular Pneumonia
52 year old male presents with a cough and fever
CT scan in the axial plane shows a lingular consolidation with air bronchograms and a positive silhouette sign. Both the superior and inferior lingular segments are involved
Ashley Davidoff MD TheCommonVein.net135190 B.A

 consolidation in the lungs

CT shows  alveolar proteinosis- central distribution which is characterized by diffuse bilateral ground-glass opacities involving both the upper and lower lobes 
Ashley Davidoff
TheCommonVein.net117513 B.A

CT shows  alveolar proteinosis- central distribution which is characterized by diffuse bilateral ground-glass opacities involving both the upper and lower lobes 
Ashley Davidoff
TheCommonVein.net117513 B.A

 consolidation in the lungs
 

CT above shows the pathologic cryptogenic organizing pneumonia (COP) which is characterized by bilateral and asymmetrical ground-glass opacities and areas of consolidation that can overlap with the ground glass opacities  Ashley Davidoff MD TheCommonVein.netlungs-COP-005-path-52f-CT B.A

CT above shows the pathologic cryptogenic organizing pneumonia (COP) which is characterized by bilateral and asymmetrical ground-glass opacities and areas of consolidation that can overlap with the ground glass opacities  Ashley Davidoff MD TheCommonVein.netlungs-COP-005-path-52f-CT B.A

 cryptogenic organizing pneumonia (COP)

A 62-year-old female patient with Sjögren?s syndrome. Axial high-resolution computed tomography scan of the chest (A) and coronal reformatting (B). In A, diffuse thickening of the bronchial walls (closed arrows), some ground-glass opacities and thin-walled cysts of varying sizes, with a diffuse, bilateral distribution (open arrows). In B, distribution predominantly in the lower fields.
Daniel Simões Oliveira et al
Radiologia Brasileira 51 (5): 321?327. web-lungs-0013.jpg B.A

A 62-year-old female patient with Sjögren?s syndrome. Axial high-resolution computed tomography scan of the chest (A) and coronal reformatting (B). In A, diffuse thickening of the bronchial walls (closed arrows), some ground-glass opacities and thin-walled cysts of varying sizes, with a diffuse, bilateral distribution (open arrows). In B, distribution predominantly in the lower fields.
Daniel Simões Oliveira et alweb-lungs-0013.jpg B.A

 cyst in the lungs
 

 Axial CT through the lower lung fields at the level of the left atrium shows desquamative interstitial pneumonia (DIP) which is characterized by diffuse ground glass changes with more prominent heterogeneity (b and c). Some of secondary lobules are expanded, with some with slightly thickened septa and prominent centrilobular nodules likely indicating small airway involvement (c, white ring).
Ashley Davidoff MD TheCommonVein.net 253Lu 136008 B.A 

  Axial CT through the lower lung fields at the level of the left atrium shows desquamative interstitial pneumonia (DIP) which is characterized by diffuse ground glass changes with more prominent heterogeneity (b and c). Some of secondary lobules are expanded, with some with slightly thickened septa and prominent centrilobular nodules likely indicating small airway involvement (c, white ring).
Ashley Davidoff MD TheCommonVein.net 253Lu 136008 B.A 
 desquamative interstitial pneumonia (DIP)
 

CHF – Alveolar Edema
CT scan shows Diffuse ground glass pattern with thickening of the interlobular septa and manifesting as crazy paving pattern
Ashley Davidoff MD TheCommonVein.net 131742 B.A

 CHF – Alveolar Edema
CT scan shows Diffuse ground glass pattern with thickening of the interlobular septa and manifesting as crazy paving pattern
Ashley Davidoff MD TheCommonVein.net 131742cL B.A		 diffuse alveolar damage (DAD)
 

Position of Disease
Subpleural Sparing
Ashley Davidoff MD TheCommonvein.net lungs-0775 0775-lo res subpleural sparing 

   diffuse lung changes
 

CXR Emphysema and Small Heart
58-year-old male presents with dyspnea. The lungs are hyperinflated with flattening of the diaphragms and increase in the retrosternal space on the lateral examination. The person also has an asthenic build with a relatively straight back and narrow A-P dimension. Frontal CXR shows a small heart with structures of the heart visualized to the right of the midline caused by compression of the low-pressure right atrium. The increased in the retrosternal airspace also compresses the relatively low pressure anteriorly positioned right ventricle. The heart is also lifted off the diaphragm (band c white arrowheads) and results in juxtaphrenic lung markings and peaks below the heart (d, arrowheads)
Ashley Davidoff MD TheCommonVein.net 136232c01L B.A

CXR Emphysema and Small Heart
58-year-old male presents with dyspnea. The lungs are hyperinflated with flattening of the diaphragms and increase in the retrosternal space on the lateral examination. The person also has an asthenic build with a relatively straight back and narrow A-P dimension. Frontal CXR shows a small heart with structures of the heart visualized to the right of the midline caused by compression of the low-pressure right atrium. The increased in the retrosternal airspace also compresses the relatively low pressure anteriorly positioned right ventricle. The heart is also lifted off the diaphragm (band c white arrowheads) and results in juxtaphrenic lung markings and peaks below the heart (d, arrowheads)
Ashley Davidoff MD TheCommonVein.net 136232c01L B.A

 emphysema


Axial CT scan with contrast shows bilateral complex and loculated effusions with thickened enhancing pleura. 
Ashley Davidoff MD TheCommonVein.net 135684 B.A
Axial CT scan with contrast shows bilateral complex and loculated effusions with thickened enhancing pleura.
Ashley Davidoff MD TheCommonVein.net 135684cL B.A		 empyema
 

CT in the axial plane shows an obstructing lesion in the left mainstem bronchus of the lung (green arrowhead) with post obstructive atelectasis of the lingula (black arrowhead) and a small portion of left upper lobe anteriorly (white arrowhead). The major fissure is displaced anteriorly.
Ashley Davidoff MD TheCommonVein.net 257Lu 136110cL B.A

CT in the axial plane shows an obstructing lesion in the left mainstem bronchus of the lung (green arrowhead) with post obstructive atelectasis of the lingula (black arrowhead) and a small portion of left upper lobe anteriorly (white arrowhead). The major fissure is displaced anteriorly.
Ashley Davidoff MD TheCommonVein.net 257Lu 136110cL B.A

 endobronchial finding

CT Extra-Pleural Fat Sign
CT  shows extra fat sign which is characterized by focal subsegmental area of atelectasis in the right lower lobe abutting the diaphragm associated with extra pleural fat proliferation secondary to the parenchymal infiltrate.
Ashley Davidoff MD TheCommonVein.net 136036c  B.A

CT Extra-Pleural Fat Sign
CT  shows extra fat sign which is characterized by focal subsegmental area of atelectasis in the right lower lobe abutting the diaphragm associated with extra pleural fat proliferation secondary to the parenchymal infiltrate.
Ashley Davidoff MD TheCommonVein.net 136036c  B.A

 extrapleural finding (fat sign)

This CT shows fissural nodules which are usually  benign round masses with well-defined margins that usually appear within fissural lines (yellow around)Ashley Davidoff MD TheCommonVein.net136201cL01 B.A

 1

This CT shows fissural nodules which are usually  benign round masses with well-defined margins that usually appear within fissural lines (yellow around)Ashley Davidoff MD TheCommonVein.net136201cL01 B.A

 fissural (nodules)
fissures fissuresL fissures
    focal lung finding

Axial CT of the chest at the level of the aortic arch shows ollicular bronchiolitis (BALT) which is characterized by centrilobular nodules, ground-glass opacities  and bronchial wall thickening. 
Ashley Davidoff MD TheCommonVein.net 132Lu 136652 B.A

Axial CT of the chest at the level of the aortic arch shows ollicular bronchiolitis (BALT) which is characterized by centrilobular nodules, ground-glass opacities  and bronchial wall thickening. 
Ashley Davidoff MD TheCommonVein.net 132Lu 136652 B.A

 follicular bronchiolitis (BALT)
    geographic changes (lungs)
 

This CT shows a ground glass nodule in the lung which is characterized by a small round hazy opacity that are usually less than 3cm in size (yellow arrows)Ashley Davidoff MD TheCommonVein.net29787L B.A

 This CT shows a ground glass nodule in the lung which is characterized by a small round hazy opacity that are usually less than 3cm in size (yellow arrows)Ashley Davidoff MD TheCommonVein.net29787cL B.A ground glass nodule in the lungs


This shows diffuse ground glass opacities involving the upper lobes and lower lobes. A finding commonly seen in patients with sarcoidosis  Ashley Davidoff MD TheCommonVein.net 029Lu 29064a002.8 B.A. 


CT shows diffuse ground glass opacities involving the upper lobes and lower lobes. A finding commonly seen in patients with sarcoidosis  Ashley Davidoff MD TheCommonVein.net 029Lu 29064a002.8 B.A

 ground glass opacity (GGO)
28-M-Normal-CXR-001L 28-M-Normal-CXR-001L02 hilum
134902-lungs-UIP  134902-lungs-UIPL  honeycomb lung
    idiopathic pulmonary fibrosis IPF (UIP radiologic equivalent?)
    incomplete fissure
135180.bronchopneumonia 135180.bronchopneumoniac infiltrate lungs (see opacity)
47152c02 47152c01e interlobular septum
    interstitial fibrosis (combined with UIP, ILD)
82-ILD-honeycomb-006-3-years-later 82-ILD-honeycomb-006-3-years-latercL interstitial lung disease
    interstitium
28-M-Normal-CXR-001L04 28-M-Normal-CXR-001L04 left paratracheal stripe
cancer-poorly-differentiated-adebocarcinoma-66f cancer-poorly-differentiated-adebocarcinoma-66fL lobulation
Lymphsadenopathy-low-demsity-TB-04-CT-5-years-ago Lymphsadenopathy-low-demsity-TB-04-CT-5-years-agoL low density lymphadenopathy (LAD)
32682n01n.800_2   lymph nodes of the chest: superior mediastinal nodes
32682n07n.800_2   lymph nodes of the chest: aortic nodes
32682n06n.800_2   lymph nodes of the chest: inferior mediastinal nodes
135804 135804c lymphadenopathy in the chest (LAD)
lungs-large-adenocarcinoma-necrosis-001-53m-CXR lungs-large-adenocarcinoma-necrosis-001-53m-CXRcL mass in the lung
heart-membranous-VSD-000b-37F-CXR-normal_L heart-membranous-VSD-000b-37F-CXR-normal_L02 mediastinal compartments
42260bb01   mediastinum
131745.8L 131745.8L02 micronodules lungs
136197 136197cL miliary nodular pattern
web-lungs-0011   mosaic attenuation pattern
heart-SLE-congestive-cardiomyopathy-mitral-regurgitation-002-CT-mucoid-impaction-40F_L   mucoid impaction lungs
    multifocal lung finding
20760c 20760c mycetoma fungal mass
web-lungs-0161b web-lungs-0161b_c nodular pattern in the lungs
72-m-lung-screen-ca-02-currentc 72-m-lung-screen-ca-02-currentcL nodule lung
    nodules interlobular septum lungs (CT)
136607 136607L nonspecific interstitial pneumonia (NSIP)
60-M-scleroderma-NSIP-006 60-M-scleroderma-NSIP-006L nonspecific interstitial pneumonia (NSIP) cellular form
136669c 136669c obliterative bronchiolitis
web-lungs-0074 web-lungs-0074 oligemia lungs
    opacity lungs
lung-COVID-Organizing-pneumonia-53M-013_OP lung-COVID-Organizing-pneumonia-53M-013_OP_L organizing pneumonia (OP)
116533.panlobular-emphysema-alpha-1-antitrypsin   panlobular emphysema
    parenchyma of lung
134273L 134273L peribronchovascular finding
    peribronchovascular interstitium
136202cl_03 136202cL_02 perilymphatic
33679c04.8c 33679c04.8c pleura (anatomy)
132135 132135.8L pleura-based finding
136550c_effusion 136550c.lungs-small-pleural-effusion pleural effusion
42016c01 42016c01L pleural plaque
134375b01L 134375b01cL pleural tag (CT)
chest-lungs-pneumomedistinum-001-CXR-trauma_c chest-lungs-pneumomedistinum-001-CXR-trauma_cL pneumomediastinum
130900c.8 130900c.8L pneumonia
b11431-004 b11431-004L pneumonitis
130979.8 130979.8c pneumopericardium
46709c02_e 46709c02 pneumothorax
lung-cancer-adenocarcinoma-pseudocavitation-001-CT-000L lung-cancer-adenocarcinoma-pseudocavitation-001-CT pseudocavity lungs
    pulmonary blood flow redistribution
COPD-Pulmonary-Fibrosis-65-003   pulmonary fibrosis
131475.8 Lungs-P-0137 pulmonary infarct
neo_interstitial_emphysema neo_interstitial_emphysema pulmonary interstitial emphysema
66M-Langerhans-017-CT-micronodules 66M-Langerhans-017-CT-micronodulescL random micronodules lungs
web-lungs-298 web-lungs-298cL respiratory bronchiolitis ILD
135741c05 135741c05c reticular pattern lungs
131990.8   reticulonodular pattern lungs
28-M-Normal-CXR-001L03 28-M-Normal-CXR-001L03 right paratracheal stripe
118433 118433c rounded atelectasis (CT)
lung-72-M-saber-trachea-001L lung-72-M-saber-trachea-001cL saber-sheath trachea
lungs-0785-lo-res-secondary-lobule.jpg   secondary lobule
32686b05L   segment of lung
118433   segmental atelectasis
bronchus-segmental-normal bronchus-segmental-normalL segmental bronchi
lungs-large-adenocarcinoma-necrosis-001-53m-CXR lungs-large-adenocarcinoma-necrosis-001-53m-CXRcL solid lung mass
rad-det-63-f-LLL-nodule-001-CXR rad-det-63-f-LLL-nodule-001-CXRcL solitary pulmonary nodule
31828L 31828cL spiculated lung lesion (CT)
83063c.8L 83063c.8L subpleural bands parenchymal bands
132089.8L 132089.8cL subpleural changes (nodules)
30602b01L02 30602b01L_subsegmental subsegmental bronchi
42106b 42106c04 tension pneumothorax
tracheobronchomalacia_insp_exp tracheobronchomalacia_insp_expL tracheomalacia,
136079 136079cL tree-in-bud appearance (CT)
web-lungs-0166 web-lungs-0166L usual interstitial pneumonia (UIP)
reticulation-70-male-uip-001-cxr reticulation-70-male-uip-001-cxrL usual interstitial pneumonia (UIP) (CXR)
75679c02 75679c03 carcinoid
135684 135684cL split pleura sign
135925lungs-inhalational-pneumoniis-crazy-paving   crazy paving
RUL   Right upper lobe
RML   Right middle lobe
RLL   Right lower lobe
LUL   Left upper lobe
LLL   Left lower lobe
web-lungs-0069 web-lungs-0069L signet ring sign
135184.ligular-pneumonia-silhouette 135184L silhouette sign (lingular PNA)
42073b02 42073b02L alveolar pattern (edema/batwing)
135865 135865 halo
47f-SLE-Sjogrens-LIP-vs-Birt-Hogg-Dube-basilar-thin-walled-cysts-lymphadenopathy-010-CT-1year-ago   lymphocytic interstitial pneumonia
    bronchomalacia
    pulmonary embolism