Diffuse Lung Diseases Clinical Features, Pathology, HRCT by Toshio Moritani, Sven Ekholm, Per-Lennart Westesson

By Toshio Moritani, Sven Ekholm, Per-Lennart Westesson

Diffusion-weighted MR imaging is generally authorized as a method to spot stroke, therefore allowing quick and potent remedy. during the last 4 years, those professional authors have provided over 30 indicates and medical stories on diffusion-weighted imaging on the RSNA and the yankee Society of Neuroradiology (ASNR), and greater than 10 of those displays were famous through particular awards. Diffusion-Weighted MR Imaging of the Brain’s chapters variety from easy ideas to interpretation of diffusion-weighted MR imaging and particular ailment. this can be a priceless reference for radiologists, neurologists, neurosurgeons in addition to citizens, fellows, radiology technologists.

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Bronchoalveolar lavage in interstitial lung disease. Curr Opin Pulm Med 2001, 7: 255 Pardo A. Increase of lung neutrophils in hypersensitivity pneumonitis is associated with lung fibrosis. Am J Respir Crit Care Med 2000, 161: 1698 Hypersensitivity Pneumonitis 49 LC Maffessanti & Dalpiaz Lymphangitic Carcinomatosis Definition Lymphangitic carcinomatosis (LC) is the metastatic spread in the lung of intra- or extrapulmonary tumors In most cases the primary tumor is located in the breast, stomach, pancreas, prostate or in the lung itself DEMOGRAPHICS Etiology and pathogenesis Lymphatic involvement may occur in three ways: hematogenous spread to the pulmonary arterioles followed by invasion of the adjacent interstitium and lymphatics with subsequent spread to the hilum or lung periphery; retrograde dissemination from mediastinal lymph nodes; communication between superior abdominal lymph nodes or lymph nodes of the peritoneal cavity and the lymphatics of the diaphragmatic pleura Epidemiology Lymphangitic carcinomatosis is a frequent pattern of cancer spread to the lungs (35-55%) Risk factors Primary neoplasm CLINICAL FEATURES History Physical findings Pulmonary function tests The onset of symptoms is insidious, although disease course is rapid (few months).

High-resolution CT appearance of diffuse alveolar septal amyloidosis. AJR Am J Roentgenol 1992, 158: 265 Distribution Bilateral, patchy Pickford HA. Thoracic cross-sectional imaging of amyloidosis. AJR Am J Roentgenol 1997, 168: 351 Dorsal subpleural Middle and basal zones Lung volume is normal Amyloidosis 29 Amyloidosis, interstitial Maffessanti & Dalpiaz Other signs Other characteristics: • Ground-glass • Consolidations or masses ( ) • Hilar-mediastinal lymphadenopathies ( D) • Pleural effusion • Thickening of the walls of the larynx, trachea and bronchi (tracheobronchial amyloidosis) Differentials The coexistence of reticular and nodular patterns significantly broadens the radiological differential diagnosis.

J Thorac Imaging 1992, 7: 1 Mayberry JP. Thoracic manifestations of systemic autoimmune diseases: radiographic and high-resolution CT findings. Radiographics 2000, 20: 1623 Other signs Other characteristics: • Honeycombing composed of minute cysts ( A) • Small centrilobular nodules • Esophageal dilatation (40-80%)( D) • Mediastinal lymphadenopathy (60%) • Pleural thickening In collagen vascular diseases honeycombing is less common and the air spaces are smaller than in UIP. Parenchymal consolidation is bilateral and can be caused by fibrosis, alveolar hemorrhage, aspiration pneumonia or OP.

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