Differential diagnosis of chest diseases Micronodular miliary disease TB Histoplasmosis Chicken box Sarcoidosis LCH Pneumoconiosis Alveolar microlithiasis Metastasis ID: 935910
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Slide1
Dr Ahmed Refaey , FRCR
Differential diagnosis
of
chest diseases
Slide2Micronodular(miliary)disease TBHistoplasmosisChicken boxSarcoidosisLCHPneumoconiosisAlveolar microlithiasisMetastasis
Slide3Septal thickeningBeaded / nodular * lymphangitic carcinomatosa * sarcoidosis * silicosisSmooth *
lymphangitisc
carcinomatosis
* pulmonary edema
* alveolar
proteinosis
Slide4Bilateral perihilar air-space diseasePulmonary edemaPulmonary hemorrhageAlveolar proteinosisPCP
Slide5Acute alveolar infiltratePulmonary edemaPneumoniaPulmonary hemorrhageAspiration
Slide6Chronic alveolar diseaseAlveolar cell carcinomaAlveolar sarcoidosisLymphomaAlveolar proteinosis
Slide7Unilateral hyperlucent lungObstructive emphysemaMcleoid syndrome ( Swyer James syndrome)PneumothoraxPulmonary embolismBullous diseaseAir trapping e.g. FB , massPoland syndrome
Slide8Multiple lung nodules (macronodules)MetastasisWegner’s granulomatosisRheumatoid n nodulesAVMsSeptic emboli
Slide9Small cavitating lung lesionsSeptic emboliRheumatoid nodulesWegner’s granulomatosisSq. or transitional cell ca metastasis
Slide10Upper lober disease( CASSET P )Cystic fibrosisAnkylosing spondylitisSarcoidosisSilicosisEsinophilic
granuloma
PCP
Slide11Basilar interstitial lung disease ( BADASS )BronchiectasisAspiration Drugs / DIP-UIPAsbestosisSickle cell diseaseScleroderma
Slide12Masses with air bronchogramLymphomaAlveolar cell carcinomaPseudolymphoma ( maltoma )
Slide13Anterior mediastinal massThymic tumorsSubsternal ThyroidLNsGerm cell tumor
Slide14Slide15Middle mediastinal massLNsAneurysmEsophageal duplicationBronchogenic cyst
Slide16Posterior mediastinal massNeurogenic tumorsParaspinal hematomaParaspinal abscessExtraskeletal hematopoiesisLNs enlargementLateral meningeocele
Slide17Opacified hemithoraxAtelectasisPneumoniaPleural effusionPost pneumonectomy
Slide18PneumomediastinumRuptured esophagusRuptured trachea / bronchusIatrogenicBroncheal asthmapneumoperitoneum
Slide19Pleural calcification Old TB empyemaAsbestos exposureHemithorax
Slide20Cardiopherenic angle massPericardial cystDiaphragmatic hernia ( Morgagni )Lung sequestration Pericardial fat bad
Slide21Unilateral pulmonary edemaAspirationDisease in other lung e.g. COPDPosturalRapid expansion pulmonary edema “ Look for ICT”
Slide22Long segment tracheal narrowingTracheopathia osteoplasticaTracheo-broncheal amyloidosisWegner’s granulomatosisIntubation injuryTracheobronchomalaciaRelapsing polychondritisPapillomatosis ( extensive )
Slide23Peripheral distributed lung diseaseEsinophilic pneumonia --- upper lobesBOOP ----- lower lobesHypersensitivity pneumonitisMultiple infarctsDIPAlveolar cell carcinoma
Slide24Bronchiectasis CT criteria of bronchiectasis1- lack of tapering of bronchi2-internal diameter of bronchus larger than the adjacent artery3- bronchi are visible within 1 cm of pleura4- mucus-filled , dilated bronchi
Slide25Bronchiectasis Chronic airway infectionPulmonary fibrosis –traction bronchiectasisABPA ------- central bronchiectasisCystic fibrosis ------- apical bronchiectasisMounier-Kuhn syndrome – tracheobronchomegallyKartagner syndrome --- situs inversus + sinusitis
Slide26Mounier-Kuhn syndrome
Slide27ABPA
Slide28Cystic fibrosis
Slide29Kartagener’s syndrome
Slide30Dilated esophagusSclerodermaAchalasiaObstructing tumorDrugs ( atropine)Surgury ( gastric pull-up)