Bronchiolitis: A Schematic Diagnostic Approach with Radiologic-pathologic Correlation

Size: px
Start display at page:

Download "Bronchiolitis: A Schematic Diagnostic Approach with Radiologic-pathologic Correlation"

Transcription

1 Bronchiolitis: A Schematic Diagnostic Approach with Radiologic-pathologic Correlation Mariana Benegas Urteaga 1, MD; M Sanchez 1, MD; J Ramirez 2, MD; D Barnes 1, MD; T de Caralt 1, MD; R J Perea 1, MD Departments of 1 Radiology and 2 Pathology Hospital Clínic- Barcelona, Spain

2 Objectives To show the classification of bronchiolitis with radio-pathological correlation To provide an easy and schematic diagnostic approach, based on HRCT findings and relevant clinical information To emphasize the role of post-processing techniques: MIP, MinIP and densitometric evaluation

3 Understanding where is the problem: normal anatomy Centrilobular region 1 cm Centrilobular artery Lobular bronchiole Poligonal shape * * Lobular artery * A normal bronchiole accompanies a pulmonary artery * and shows a thin rim of smooth muscle and a thin layer of surrounding connective tissue within its wall Pulmonary vein Interlobular septa sometimes visible The secondary pulmonary lobule is the smallest unit of lung that is delineated by connective tissue septa and measure from 1 to 2,5 cm

4 Bronchioles Small airways that do not contain cartilage and mucous glands in their walls Internal diameter of 2 mm or less Bronchioles cannot be seen on CT Diseased bronchioles with dilated lumen or thickened walls can be visuallized on CT Lobular bronchiole Terminal bronchiole Alveolar ducts Alveoli Membranous bronchiole Respiratory bronchiole S E C O N D A R Y P U L M O N A R Y L O B U L E

5 Bronchiolitis- Small Airways Diseases Bronchiolitis or small airways diseases is a generic term used clinically to describe various inflammatory diseases of the bronchioles. Means an inflammation of the bronchiolar wall usually centered in and around the membranous and terminal bronchioles Relatively common diseases Symptoms and chest Rx are nonspecific Confusing terminology There are multiple classifications Etiologic Classification Pathological Classification CT Classification Lobular bronchiole Membranous bronchioles Terminal bronchiole TC is the imaging technique of choice for suspected bronchiolitis Respiratory bronchiole

6 Classifications of Bronchiolitis Primary bronchiolar disorders Respiratory bronchiolitis Acute bronchiolitis Constrictive bronchiolitis (Obliterative bronchiolitis) Follicular bronchiolitis Diffuse panbronchiolitis Mineral dust airway disease Bronchiolar involvement in interstitial lung diseases Hypersensitivity pneumonitis Respiratory bronchiolitis associated interstitial lung disease/desquamative interstitial pneumonia Organizing pneumonia Other interstitial lung disease: Sarcoidosis, Pulmonary Langerhans cell histiocytosis, idiopathic pulmonary fibrosis Bronchiolar involvement in large airway diseases Chronic bronchitis, Bronchiectasis, Asthma Ryu JH, Myers JL, Swensen SJ. Bronchiolar disorders. Am J Respir Crit Care Med Dec 1;168(11): Review.

7 Pathological Classification Cellular bronchiolitis Infectious bronchiolitis Hypersensivity pneumonitis Follicular bronchiolitis Panbronchiolitis Respiratory bronchiolitis/rb-ild Constrictive bronchiolitis Secondary (associated with infections, drugs, collagen, vascular diseases, transplantation) Idiopatic Bronchiolitis obliterans with intraluminal polips Idiopatic or Secondary Now is considered an idiopatic interstitial pneumonia (COP)

8 Cellular bronchiolitis Cellular inflammation of the bronchiolar wall and intraluminal exudates Constrictive bronchiolitis Peribronchiolar fibrosis with extrinsic compression and obliteration of the airway Bronchiolitis obliterans with intraluminal polips Polipoid intraluminal plugs of proliferating fibroblasts within alveolar ducts and spaces

9 How can I recognize a bronchiolitis on CT? DIRECT SIGNS Direct visualization of the diseased bronchioles INDIRECTS SIGNS Changes in the lung parenchyma distal to the obstruction of the bronchiolar lumen Tree-in-bud opacities Poorly defined centrilobular nodules Bronchiolectasis Mosaic attenuation Air trapping Bronchiolar wall thickening and occupation of the bronchiolar lumen (fluid, mucus, pus) Peribronchiolar inflammation Bronchiolar dilatation C E L L U L A R C O N S T R I C T I V E

10 Direct Signs Lobular bronchioles are usually not directly visible on CT because its wall is too thin But they can become visible at the center of the secondary lobule when there is increased soft tissue in or around the bronchioles Tree-in-bud opacities: resembles a budding tree Centrilobular noduls and V or Y- shaped branching linear opacities Dilatation and impactation of centrilobular bronchioles by pus or mucus (the branches) associated of peribronchiolar inflammation or fibrosis (the buds). It is almost due to INFECTION NOT specific to the type of infection Bacterial and mycobacterial are most frequent BRONCHIECTASIS or bronchial wall thickening may be present depending on the cause or duration of the infection

11 Direct Signs: tree-in-bud opacities Tree-in-bud opacities is generally taken to mean that infection is present. Describe this finding only when you are sure that is present. The use of MIP has been proved to increase the number of bronchiolar centrilobular opacities compared with single thin-section CT scan in patients with infectious or inflammatory bronchiolitis Rémy Jardin M et al. Spiral CT of the Chest. Springer-Verlag 1996

12 Vascular tree-in bud Tumor emboli Tumoral thrombotic microangio pathy Franquet et al. AJR 2002;179(4):897-9 Differential diagnosis of the tree-in-bud pattern Infections Infectious variants Bacterial, mycobacterial, fungal, viral infections Cystic fibrosis, Ciliary disorders, Immunodeficiency, Panbronchiolitis, Allergic bronchopulmonary aspergillosis Cortesy Dra Eva Castañer SDI UDIAT 44 year-old patient without medical history Clinically PE suspected without evidence in angioct The patient died 2 days after admission Autopsy: pulmonary tumor thrombotic microangiopathy Noninfectious bronchiolar diseases Vascular abnormalities Perilymphatic diseases Invasive mucinous adenocarcinoma, Follicular bronchiolitis, Aspiration Talcosis, Intravascular metastases Sarcoidosis

13 Direct Signs: centrilobular nodules Poorly defined Centrilobular nodules of ground glass opacity Differential diagnosis of centrilobullar nodules Hypersensitivity pneumonitis Respiratory bronchiolitis Respiratory bronchiolitis with interstitial lung disease Follicular bronchiolitis Inflammatory cellular or fibrosis surrounding the centrilobular bronchiole. Impactation of bronchiole is tipically absent. Tend to be fairly homogeneous in size Pneumoconioses Collagen vascular diseases Atypical infections

14 Direct Signs: Bronchiolectasis BRONCHIOLECTASIS may be air filled or filled with secretions. Luminal impactation + wall thickening Tree-in-bud opacities Probably an infection Commonly are associated with large airways abnormalities Dilated bronchioles visualized in the peripheral 1 to 2 cm of the lung wich is not normal

15 Indirect signs Mosaic attenuation: visualized on inspiratory CT Air trapping: is an indirect sign of obstructive small airways disease that is accentuated on expiratory CT * * * * Expiratory CT is the key When mosaic attenuation/air trapping is the only or predominant finding the differential diagnosis is quite limited Inspiration Expiration Differential Diagnosis of isolated Mosaic Attenuation Asthma Hypersensitivity pneumonitis Constrictive bronchiolitis Vascular diseases (CTEPH, vasculitis)

16 Indirect signs MinIP: increase the contrast between areas of normal lung attenuation and areas of lung hyppoattenuation facilitating the depiction of mosaic pattern. Improve the detection of air trapping. Fotheringhan el al. JCAT 1999;23: Wiltram et al. JThoracImaging 20002;7:47-52 Quantitative assessment of air trapping -860 HU -950 HU (expiration)= air trapping Quantitative expiratory CT with LLL air trapping Chabat et al. J CAT 2000;24: Matsuoka et al.ajr 2008; 190:

17 Interpretation of air trapping Inspiration Expiration Air trapping with normal inspiratory CT - Constrictive bronchiolitis - Asthma - Smokers - Hypersensitivity pneumonitis - Sarcoidosis Interpretation of expiratory CT is complicated: in approximately 50% of asymptomatic subjects lobular areas of air trapping may be depicted on expiratory CT in dependent portions of the lung. Increase with age (1) and should be ignored in the absence of physiologic evidence of airway obstruction (2) (1)Lee et al. Radiology 2000;214: (2)Tanaka el al. Radiology 2003;227:

18 Mosaic Attenuation Pattern Decrease in size of pulmonary vessels Uniform size vessels No air trapping Air trapping No air trapping Vascular disease Obstructive disease Infiltrative disease Chronic PE Airways disease Ground-glass

19 CT Patterns of Small Airways Disease CT Findings Pathophysiology Common diseases Tree-in-bud Pattern Centrilobular nodules of ground-glass opacity Mosaic pattern/air trapping Infectious mucoid impactation of bronchioles Peribronchial inflammation or fibrosis Bronchiolar narrowing or occlusion Endobronchial infections Aspiration Hypersensitivity pneumonitis Respiratory bronchiolitis Follicular bronchiolitis Atypical infections Pneumoconiosis Constrictive bronchiolitis Hypersensitivity pneumonitis C E L L U L A R CONSTRICTIVE

20 What do they have in common? Tree-in-bud Pattern + Centrilobular Nodules A Cellular Bronchiolitis B more Frequent Infectious Bronchiolitis C D

21 How do they differ? 35-year-old Immunocompetent Clinical Presentation Medical history Other CT findings 50-year-old ACUTE Immunocompromised (neutropenic) Bronchiectasis Viral infection CHRONIC Airway-invasive Aspergillosis Cavitation Nontuberculous Mycobacterial infection 70-year-old Immunocompetent women Tuberculosis 80-year-old Immunocompetent

22 Infectious Bronchiolitis Cellular Bronchiolitis CMV Mycobacterium abscessus Pseudomonas aeruginosa Mycobacterium avium-intracellulare Haemophilus influenzae Lady Windermere Syndrome -MAC and M. kansasii -lingula and middle lobe -Bronchiectasis -Elderly women -Chronic cough

23 Infectious Bronchiolitis- Aspergillosis Airway-Invasive Aspergillosis 1/3 of invasive aspergillosis Immunocompromised neutropenic patients Traqueobronchitis Bronchiolitis Bronchopneu monia Aspergillus deep to the airway basement membrane Buckingham et al. Eur Radiol 2003;13: * Allergic bronchopulmonary aspergillosis (ABPA) - Asthmatic - Large airways findings (bronchiectasis and bronchial impactation) (black asterisk) - Tree-in-bud may also be present (red arrow)

24 Cellular Bronchiolitis- Follicular Bronchiolitis Tree-in-bud +/- centrilobular nodules of ground glass opacity 30-year-old women with Sjogren s disease and respiratory symptoms Associated with collagen vascular diseases, particularly rheumatoid arthritis, Sjogren syndrome and immunocompromised patients Cellular bronchiolitis with lymphoid follicle formation in relationto the bronchiole FB and lymphoid interstitial pneumonia represent a spectrum of the same disease Pipavath et al.ajr 2005;185: A Fig A:Florid hyperplasia of peribronchiolar lymphoid follicles with compression and narrrowing of airways lumen

25 Cellular Bronchiolitis- Hypersensitivity Pneumonitis Centrilobular nodules pattern Young woman with dyspnea Represent a reaction to inhaled organic antigens Airways abnormalities most evident in the subacute stage Chronic Hypersensitivity Pneumonitis: Air trapping with mosaic attenuation pattern associated Increased with intensity fibrosis of inflammation around the airway Silva et al.ajr 2007; 188: Air trapping in lower lobes Centrilobular nodules of ground-glass opacity are usually diffuse, poorly defined and with symmetric distribution Areas of mosaic attenuation due to air trapping are frequent Small granulomas are seen adyacent to a bronchiole

26 Cellular Bronchiolitis- Respiratory Bronchiolitis Smoker with dyspnea Ill-defined centrilobular nodules Air trapping Increased numbers of pigmented macrophages within a bronchiolar lumen and surrounding alveoli, with associated non specific chronic inflammation and fibrosis in peribronchiolar alveolar walls Smoking-related disease with Desquamative interstitial pneumonia (spectrum of the same pathological process) Common finding in smokers, often asymptomatic Ill-defined centrilobular nodules of ground-glass opacity, often indistinguishable from HP Air trapping Predominance in upper lobes Emphysema may develop

27 Constrictive Bronchiolitis- Indirect Signs Causes of Constrictive Bronchiolitis Post-viral infection - Childhood viral infection (adenovirus, respiratory syncytial virus) - Adults and children (Mycoplasma, Pneumocystis jirovecii in AIDS, endobronchial spread of tuberculosis) Transplant-related bronchiolitis - Graft vs. Host disease - Chronic rejection in heart-lung or lung transplant Connective tissue disease (Rheumatoid arthritis, Sjogren) Drug toxicity (penicillamine, gold, cocaine) Neuroendocrine Cell Hyperplasia and multiple carcinoid tumorlets Inflammatory bowel diseases Inhalationl injury (nitrogen dioxide, sulfur dioxide, amonia)

28 Postinfectious Bronchiolitis- Swyer-James-McLeod s Syndrome Classically described as Unilateral Constrictive bronchiolitis in chest x ray On CT we can observe this type of bronchiolitis segmental, lobar, uni o bilateral. Focal areas of decreased lung opacity with sharp margins Decreased lung volume and reduction in the size of pulmonary artery branches Bronchial wall thickening and bronchiectasis

29 Transplant-related bronchiolitis Hematopoietic cell trasplantation Allogeneic Associated with graft-versus-host disease 6 months to 2 years after. Incidence 6-26% Imaging findings and symptoms are identical to those found with BO after lung transplantation Incidence 50-70% after 5 years BO vs Bronchiolitis Obliterans Syndrome (BOS) CT: Air trapping Mosaic attenuation pattern Bronchiectasis Bronchial wall thickening

30 Bronchiolitis obliterans INSPIRATION EXPIRATION

31 Neuroendocrine cell hyperplasia 40 year-old woman with Sjogren Syndrome and nonspecific respiratory symptoms A C B C Fig A and B: MinIP shows heterogeneos lung density with sharply demarcated regions of decreased lung attenuation compatible with mosaic attenuation pattern Fig C and D: small scattered pulmonary nodules

32 Neuroendocrine cell hyperplasia Intraepithelial nodules of neuroendocrine cells with tumourlets Association with carcinoide tumour Asymptomatics- dyspnea CT: Mosaic attenuation pattern +/- nodules Davies et al.thorax 2007;62: Lee et al. JCAT 2002;26;180.84

33 Criado E et al.pulmonary sarcoidosis: typical and atypical manifestations at high-resolution CT with pathologic correlation. Radiographics Oct;30(6): Constrictive Bronchiolitis Sarcoidosis Air trapping at expiratory CT Granulomas in the bronchiolar wall

34 Algorithm for the interpretation of bronchiolitis 1- CT Pattern Direct Signs Indirect Signs Tree-in-bud Centrilobular nodules Air Trapping Mosaic attenuation pattern Cellular/Inflammatory Bronchiolitis Constrictive Bronchiolitis 2-Clinical Presentation 3-Clinical Information Infection Acute Chronic Immunocompetent Immunocompromised patient Hypersensitivity Pneumonitis Respiratory bronchiolitis Follicular bronchiolitis Inhaled organic antigens, smoker, collagen vascular disease -Transplant -Prior infections -Drugs -Toxic fume exposure

35 Conclusions Small airways diseases have a quite broad clinical diagnosis The diagnosis of bronchiolitis is often suggested by CT findings There is a correlation between radiographic signs and the different pathological types of bronchiolitis The recognition of the CT pattern associated with the clinical information allows the formulation of a focused differential diagnosis The radiological reports may not only be descriptive but has to refined the diagnosis helping the clinicians to choose the therapeutic options

Imaging Small Airways Diseases: Not Just Air trapping. Eric J. Stern MD University of Washington

Imaging Small Airways Diseases: Not Just Air trapping. Eric J. Stern MD University of Washington Imaging Small Airways Diseases: Not Just Air trapping Eric J. Stern MD University of Washington What we are discussing SAD classification SAD imaging with MDCT emphasis What is a small airway? Airway with

More information

Acute and Chronic Lung Disease

Acute and Chronic Lung Disease KATHOLIEKE UNIVERSITEIT LEUVEN Faculty of Medicine Acute and Chronic Lung Disease W De Wever, JA Verschakelen Department of Radiology, University Hospitals Leuven, Belgium Clinical utility of HRCT To detect

More information

Bronchiectasis: An Imaging Approach

Bronchiectasis: An Imaging Approach Bronchiectasis: An Imaging Approach Travis S Henry, MD Associate Professor of Clinical Radiology Cardiac and Pulmonary Imaging Section University of California, San Francisco Large Middle Small 1 Bronchiectasis

More information

Residents Section Pattern of the Month

Residents Section Pattern of the Month Residents Section Pattern of the Month Gosset et al. Tree-In-Bud Pattern Residents Section Pattern of the Month Residents inradiology Natacha Gosset 1 Alexander A. Bankier Ronald L. Eisenberg Gosset N,

More information

11/10/2014. Multi-disciplinary Approach to Diffuse Lung Disease: The Imager s Perspective. Radiology

11/10/2014. Multi-disciplinary Approach to Diffuse Lung Disease: The Imager s Perspective. Radiology Multi-disciplinary Approach to Diffuse Lung Disease: The Imager s Perspective Radiology Pathology Clinical 1 Role of HRCT Diagnosis Fibrosis vs. inflammation Next step in management Response to treatment

More information

An Image Repository for Chest CT

An Image Repository for Chest CT An Image Repository for Chest CT Francesco Frajoli for the Chest CT in Antibody Deficiency Group An Image Repository for Chest CT he Chest CT in Antibody Deficiency Group is an international and interdisciplinary

More information

Financial disclosure COMMON DIAGNOSES IN HRCT. High Res Chest HRCT. HRCT Pre test. I have no financial relationships to disclose. Anatomy Nomenclature

Financial disclosure COMMON DIAGNOSES IN HRCT. High Res Chest HRCT. HRCT Pre test. I have no financial relationships to disclose. Anatomy Nomenclature Financial disclosure I have no financial relationships to disclose. Douglas Johnson D.O. Cardiothoracic Imaging Gaston Radiology COMMON DIAGNOSES IN HRCT High Res Chest Anatomy Nomenclature HRCT Sampling

More information

The Pathologic Manifestations of Small Airway Disease. Samuel A. Yousem, MD. Small Airway Disease (SAD) SAD

The Pathologic Manifestations of Small Airway Disease. Samuel A. Yousem, MD. Small Airway Disease (SAD) SAD The Pathologic Manifestations of Small Airway Disease Samuel A. Yousem, MD Small Airway Disease (SAD) A clinicopathologic syndrome reflecting a CHRONIC inflammatory and cicatricial process primarily affecting

More information

5/9/2015. Multi-disciplinary Approach to Diffuse Lung Disease: The Imager s Perspective. No, I am not a pulmonologist! Radiology

5/9/2015. Multi-disciplinary Approach to Diffuse Lung Disease: The Imager s Perspective. No, I am not a pulmonologist! Radiology Multi-disciplinary Approach to Diffuse Lung Disease: The Imager s Perspective No, I am not a pulmonologist! Radiology Pathology Clinical 1 Everyone needs a CT Confidence in diagnosis Definitive HRCT +

More information

Small airway disease: semiological and radiological evaluation. A pictorial review.

Small airway disease: semiological and radiological evaluation. A pictorial review. Small airway disease: semiological and radiological evaluation. A pictorial review. Award: Magna Cum Laude Poster No.: C-3028 Congress: ECR 2018 Type: Educational Exhibit Authors: K. N. Nieto, A. Cerpa,

More information

HRCT in Diffuse Interstitial Lung Disease Steps in High Resolution CT Diagnosis. Where are the lymphatics? Anatomic distribution

HRCT in Diffuse Interstitial Lung Disease Steps in High Resolution CT Diagnosis. Where are the lymphatics? Anatomic distribution Steps in High Resolution CT Diagnosis Pattern of abnormality Distribution of disease Associated findings Clinical history Tomás Franquet MD What is the diagnosis? Hospital de Sant Pau. Barcelona Secondary

More information

Outline Definition of Terms: Lexicon. Traction Bronchiectasis

Outline Definition of Terms: Lexicon. Traction Bronchiectasis HRCT OF IDIOPATHIC INTERSTITIAL PNEUMONIAS Disclosures Genentech, Inc. Speakers Bureau Tadashi Allen, MD University of Minnesota Assistant Professor Diagnostic Radiology 10/29/2016 Outline Definition of

More information

an inflammation of the bronchial tubes

an inflammation of the bronchial tubes BRONCHITIS DEFINITION Bronchitis is an inflammation of the bronchial tubes (or bronchi), which are the air passages that extend from the trachea into the small airways and alveoli. Triggers may be infectious

More information

Liebow and Carrington's original classification of IIP

Liebow and Carrington's original classification of IIP Liebow and Carrington's original classification of IIP-- 1969 Eric J. Stern MD University of Washington UIP Usual interstitial pneumonia DIP Desquamative interstitial pneumonia BIP Bronchiolitis obliterans

More information

Lung Allograft Dysfunction

Lung Allograft Dysfunction Lung Allograft Dysfunction Carlos S. Restrepo M.D. Ameya Baxi M.D. Department of Radiology University of Texas Health San Antonio Disclaimer: We do not have any conflict of interest or financial gain to

More information

Sudhakar J. Pipavath 1,2 David A. Lynch 3 Carlyne Cool 3 Kevin K. Brown 4 John D. Newell 4

Sudhakar J. Pipavath 1,2 David A. Lynch 3 Carlyne Cool 3 Kevin K. Brown 4 John D. Newell 4 Pipavath et al. Radiologic and Pathologic Features of Bronchiolitis Chest Imaging Perspective Sudhakar J. Pipavath 1,2 David A. Lynch 3 Carlyne Cool 3 Kevin K. Brown 4 John D. Newell 4 Pipavath SJ, Lynch

More information

HYPERSENSITIVITY PNEUMONITIS

HYPERSENSITIVITY PNEUMONITIS HYPERSENSITIVITY PNEUMONITIS A preventable fibrosis MOSAVIR ANSARIE MB., FCCP INTERSTITIAL LUNG DISEASES A heterogeneous group of non infectious, non malignant diffuse parenchymal disorders of the lower

More information

PULMONARY TUBERCULOSIS RADIOLOGY

PULMONARY TUBERCULOSIS RADIOLOGY PULMONARY TUBERCULOSIS RADIOLOGY RADIOLOGICAL MODALITIES Medical radiophotography Radiography Fluoroscopy Linear (conventional) tomography Computed tomography Pulmonary angiography, bronchography Ultrasonography,

More information

The term bronchiolitis has been used to refer to a broad

The term bronchiolitis has been used to refer to a broad SYMPOSIA Imaging of Small Airways Disease Gerald F. Abbott, MD,* Melissa L. Rosado-de-Christenson, MD,w zy Santiago E. Rossi, MD,J and Saul Suster, MDz Abstract: Small airways disease includes a spectrum

More information

Micronodular lung pattern - Differential diagnosis

Micronodular lung pattern - Differential diagnosis Micronodular lung pattern - Differential diagnosis Poster No.: P-0074 Congress: ESTI 2015 Type: Educational Poster Authors: P. Ninitas, F. Marinho, P. Campos, I. Távora ; Lisbon/PT, 1 2 2 3 1 1 3 Funchal/PT,

More information

Thoracic lung involvement in rheumatoid arthritis: Findings on HRCT

Thoracic lung involvement in rheumatoid arthritis: Findings on HRCT Thoracic lung involvement in rheumatoid arthritis: Findings on HRCT Poster No.: C-2488 Congress: ECR 2015 Type: Educational Exhibit Authors: R. E. Correa Soto, M. J. Martín Sánchez, J. M. Fernandez 1 1

More information

Immunocompromised patients. Immunocompromised patients. Immunocompromised patients

Immunocompromised patients. Immunocompromised patients. Immunocompromised patients Value of CT in Early Pneumonia in Immunocompromised Patients Nantaka Kiranantawat, PSU Preventative Factors Phagocyts Cellular immunity Humoral immunity Predisposing Factors Infection, Stress, Poor nutrition,

More information

Hypersensitivity Pneumonitis: Spectrum of High-Resolution CT and Pathologic Findings

Hypersensitivity Pneumonitis: Spectrum of High-Resolution CT and Pathologic Findings CT of Hypersensitivity Pneumonitis Chest Imaging Pictorial Essay C. Isabela S. Silva 1 ndrew Churg 2 Nestor L. Müller 1 Silva CIS, Churg, Müller NL Keywords: high-resolution CT, hypersensitivity pneumonitis,

More information

Bronkhorst colloquium Interstitiële longziekten. Katrien Grünberg, klinisch patholoog

Bronkhorst colloquium Interstitiële longziekten. Katrien Grünberg, klinisch patholoog Bronkhorst colloquium 2013-2014 Interstitiële longziekten De pathologie achter de CT Katrien Grünberg, klinisch patholoog K.grunberg@vumc.nl Preparing: introduction and 3 cases The introduction on microscopic

More information

Respiratory Pathology. Kristine Krafts, M.D.

Respiratory Pathology. Kristine Krafts, M.D. Respiratory Pathology Kristine Krafts, M.D. Normal lung: alveolar spaces Respiratory Pathology Outline Acute respiratory distress syndrome Obstructive lung diseases Restrictive lung diseases Vascular

More information

HRCT Versus Volume Rendering (Three Colors, Three Densities Lung Images) in Diagnosis of Small Airway Disease: A Comparative Study

HRCT Versus Volume Rendering (Three Colors, Three Densities Lung Images) in Diagnosis of Small Airway Disease: A Comparative Study Med. J. Cairo Univ., Vol. 84, No. 1, March: 359-364, 2016 www.medicaljournalofcairouniversity.net HRCT Versus Volume Rendering (Three Colors, Three Densities Lung Images) in Diagnosis of Small Airway Disease:

More information

Vascular Lung Diseases

Vascular Lung Diseases Vascular Lung Diseases SESSION SPECIFIC OBJECTIVES List the major types of vascular lung disease Recognize and describe the pathology of vascular lung disease: Pulmonary embolism, thrombosis, hypertension,

More information

Case 1 : Question. 1.1 What is the intralobular distribution? 1. Centrilobular 2. Perilymphatic 3. Random

Case 1 : Question. 1.1 What is the intralobular distribution? 1. Centrilobular 2. Perilymphatic 3. Random Interesting case Case 1 Case 1 : Question 1.1 What is the intralobular distribution? 1. Centrilobular 2. Perilymphatic 3. Random Case 1: Answer 1.1 What is the intralobular distribution? 1. Centrilobular

More information

Swyer-James Syndrome: An Infrequent Cause Of Bronchiectasis?

Swyer-James Syndrome: An Infrequent Cause Of Bronchiectasis? ISPUB.COM The Internet Journal of Pulmonary Medicine Volume 12 Number 1 Swyer-James Syndrome: An Infrequent Cause Of Bronchiectasis? A Huaringa, S Malek, M Haro, L Tapia Citation A Huaringa, S Malek, M

More information

Airways Disease MDT - 6th May 2014

Airways Disease MDT - 6th May 2014 Airways Disease MDT - 6th May 2014 The inaugural AD-MDT was held on 6/5/14. The AIM of the meeting is to develop the skills and knowledge to be able to run an AD-MDT - the time frame from the start to

More information

Differential diagnosis

Differential diagnosis Differential diagnosis Idiopathic pulmonary fibrosis (IPF) is part of a large family of idiopathic interstitial pneumonias (IIP), one of four subgroups of interstitial lung disease (ILD). Differential

More information

Usual Interstitial pneumonia and Nonspecific Interstitial Pneumonia. Nitra and the Gangs.

Usual Interstitial pneumonia and Nonspecific Interstitial Pneumonia. Nitra and the Gangs. Usual Interstitial pneumonia and Nonspecific Interstitial Pneumonia Nitra and the Gangs. บทน ำและบทท ๓, ๑๐, ๑๒, ๑๓, ๑๔, ๑๕, ๑๗ Usual Interstitial Pneumonia (UIP) Most common & basic pathologic pattern

More information

NONE OVERVIEW FINANCIAL DISCLOSURES UPDATE ON IDIOPATHIC PULMONARY FIBROSIS/IPF (UIP) FOR PATHOLOGISTS. IPF = Idiopathic UIP Radiologic UIP Path UIP

NONE OVERVIEW FINANCIAL DISCLOSURES UPDATE ON IDIOPATHIC PULMONARY FIBROSIS/IPF (UIP) FOR PATHOLOGISTS. IPF = Idiopathic UIP Radiologic UIP Path UIP UPDATE ON IDIOPATHIC PULMONARY FIBROSIS/IPF () FOR PATHOLOGISTS Thomas V. Colby, M.D. Professor of Pathology (Emeritus) Mayo Clinic Arizona FINANCIAL DISCLOSURES NONE OVERVIEW IPF Radiologic Dx Pathologic

More information

Cystic Lung Disease. Cristopher A. Meyer, MD

Cystic Lung Disease. Cristopher A. Meyer, MD Cystic Lung Disease Cristopher A. Meyer, MD Air filled structure with definable wall typically less than 1 mm thick Cris A. Meyer, M.D. Professor of Radiology University of Wisconsin School of Medicine

More information

Radiologic Approach to Smoking Related Interstitial Lung Disease

Radiologic Approach to Smoking Related Interstitial Lung Disease Radiologic Approach to Smoking Related Interstitial Lung Disease Poster No.: C-1854 Congress: ECR 2013 Type: Educational Exhibit Authors: K.-N. Lee, J.-Y. Han, E.-J. Kang, J. Kang; Busan/KR Keywords: Toxicity,

More information

Unit II Problem 2 Pathology: Pneumonia

Unit II Problem 2 Pathology: Pneumonia Unit II Problem 2 Pathology: Pneumonia - Definition: pneumonia is the infection of lung parenchyma which occurs especially when normal defenses are impaired such as: Cough reflex. Damage of cilia in respiratory

More information

Smoking-related Interstitial Lung Diseases: High-Resolution CT Findings

Smoking-related Interstitial Lung Diseases: High-Resolution CT Findings Smoking-related Interstitial Lung Diseases: High-Resolution CT Findings Poster No.: C-2358 Congress: ECR 2013 Type: Educational Exhibit Authors: V. Cuartero Revilla, M. Nogueras Carrasco, P. Olmedilla

More information

October 2012 Imaging Case of the Month. Michael B. Gotway, MD Associate Editor Imaging. Department of Radiology Mayo Clinic Arizona Scottsdale, AZ

October 2012 Imaging Case of the Month. Michael B. Gotway, MD Associate Editor Imaging. Department of Radiology Mayo Clinic Arizona Scottsdale, AZ October 2012 Imaging Case of the Month Michael B. Gotway, MD Associate Editor Imaging Department of Radiology Mayo Clinic Arizona Scottsdale, AZ Clinical History: A 65-year-old non-smoking woman presented

More information

I have no relevant conflicts of interest to disclose

I have no relevant conflicts of interest to disclose I have no relevant conflicts of interest to disclose Diffuse parenchymal lung disease (DPLD) and its associations Secondary lobular anatomy DPLD History, clinical findings, temporal evolution, and exposures

More information

Atopic Pulmonary Disease: Findings on Thoracic Imaging

Atopic Pulmonary Disease: Findings on Thoracic Imaging July 2003 Atopic Pulmonary Disease: Findings on Thoracic Imaging Rebecca G. Breslow Harvard Medical School Year IV Churg-Strauss Syndrome Hypersensitivity Pneumonitis Asthma Atopic Pulmonary Disease Allergic

More information

The Pulmonary Pathology of Iatrogenic Immunosuppression. Kevin O. Leslie, M.D. Mayo Clinic Scottsdale

The Pulmonary Pathology of Iatrogenic Immunosuppression. Kevin O. Leslie, M.D. Mayo Clinic Scottsdale The Pulmonary Pathology of Iatrogenic Immunosuppression Kevin O. Leslie, M.D. Mayo Clinic Scottsdale The indications for iatrogenic immunosuppression Autoimmune/inflammatory disease Chemotherapy for malignant

More information

Chronic Cough Due to Nonbronchiectatic Suppurative Airway Disease (Bronchiolitis) ACCP Evidence-Based Clinical Practice Guidelines

Chronic Cough Due to Nonbronchiectatic Suppurative Airway Disease (Bronchiolitis) ACCP Evidence-Based Clinical Practice Guidelines Chronic Cough Due to Nonbronchiectatic Suppurative Airway Disease (Bronchiolitis) ACCP Evidence-Based Clinical Practice Guidelines Kevin K. Brown, MD, FCCP Objectives: To review the role of nonbronchiectatic

More information

Micronodular Lung Disease an algorithm

Micronodular Lung Disease an algorithm Micronodular Lung Disease an algorithm H. Page McAdams, MD Department of Radiology Duke University Medical Center Durham, NC USA page.mcadams@duke.edu Question Which of the following lung diseases is MOST

More information

Pediatric High-Resolution Chest CT

Pediatric High-Resolution Chest CT Pediatric High-Resolution Chest CT Alan S. Brody, MD Professor of Radiology and Pediatrics Chief, Thoracic Imaging Cincinnati Children s s Hospital Cincinnati, Ohio, USA Pediatric High-Resolution CT Short

More information

Bronchiolar disorders: Current perspective on diagnosis & management. Puneet Malhotra Senior Resident, Dept. of Pulmonary Medicine, PGIMER

Bronchiolar disorders: Current perspective on diagnosis & management. Puneet Malhotra Senior Resident, Dept. of Pulmonary Medicine, PGIMER Bronchiolar disorders: Current perspective on diagnosis & management Puneet Malhotra Senior Resident, Dept. of Pulmonary Medicine, PGIMER Anatomic considerations Classification Diagnostic approach Specific

More information

4.6 Small airways disease

4.6 Small airways disease 4.6 Small airways disease Author: Jean-Marc Fellrath 1. INTRODUCTION Small airways are defined as any non alveolated and noncartilaginous airway that has an internal diameter of 2 mm. Several observations

More information

Nontuberculous Mycobacterial Lung Disease

Nontuberculous Mycobacterial Lung Disease Non-TB Mycobacterial Disease Jeffrey P. Kanne, MD Nontuberculous Mycobacterial Lung Disease Jeffrey P. Kanne, M.D. Consultant Disclosures Perceptive Informatics Royalties (book author) Amirsys, Inc. Wolters

More information

Hypothesis on the Evolution of Cavitary Lesions in Nontuberculous Mycobacterial Pulmonary Infection: Thin-Section CT and Histopathologic Correlation

Hypothesis on the Evolution of Cavitary Lesions in Nontuberculous Mycobacterial Pulmonary Infection: Thin-Section CT and Histopathologic Correlation CT of Nontuberculous Mycobacterial Pulmonary Infection Tae Sung Kim 1 Won-Jung Koh 2 Joungho Han 3 Myung Jin Chung 1 Ju Hyun Lee 1 Kyung Soo Lee 1 O Jung Kwon 2 Kim TS, Koh W-J, Han J, et al. Received

More information

Systemic lupus erythematosus (SLE): Pleuropulmonary Manifestations

Systemic lupus erythematosus (SLE): Pleuropulmonary Manifestations 08/30/10 09/26/10 Systemic lupus erythematosus (SLE): Pleuropulmonary Manifestations Camila Downey S. Universidad de Chile, School of Medicine, Year VII Harvard University, School of Medicine Sept 17,

More information

Diagnostic Evaluation of NTM and Bronchiectasis

Diagnostic Evaluation of NTM and Bronchiectasis Division of Pulmonary, Critical Care and Sleep Medicine Diagnostic Evaluation of NTM and Bronchiectasis Ashwin Basavaraj, MD, FCCP NTM patient education program November 9, 2016 Involves a combination

More information

Small airways diseases, excluding asthma and COPD: an overview

Small airways diseases, excluding asthma and COPD: an overview Eur Respir Rev 2013; 22: 128, 131 147 DOI: 10.1183/09059180.00001313 CopyrightßERS 2013 REVIEW Small airways diseases, excluding asthma and COPD: an overview Pierre-Régis Burgel, Anne Bergeron, Jacques

More information

Pathology of Pneumonia

Pathology of Pneumonia Pathology of Pneumonia Dr. Atif Ali Bashir Assistant Professor of Pathology College of Medicine Majma ah University Introduction: 5000 sq meters of area.! (olympic track) Filters >10,000 L of air / day!

More information

NON-CF BRONCHIECTASIS IN ADULTS

NON-CF BRONCHIECTASIS IN ADULTS Séminaire de Pathologie Infectieuse Jeudi 25 juin 2008 Cliniques Universitaires UCL de Mont-Godinne, Yvoir NON-CF BRONCHIECTASIS IN ADULTS Dr Robert Wilson Royal Brompton Hospital, London, UK Aetiology

More information

Disease spectrum. IPA Invasive pulmonary aspergillosis

Disease spectrum. IPA Invasive pulmonary aspergillosis Aspergillus & ABPA Disease spectrum IPA Invasive pulmonary aspergillosis ABPA ABPA pathophysiology conidia of Aspergillus trapped in mucous and narrowed airways of asthmatics/cf germinate to form hyphae

More information

Differential diagnosis

Differential diagnosis Differential diagnosis The onset of COPD is insidious. Pathological changes may begin years before symptoms appear. The major differential diagnosis is asthma, and in some cases, a clear distinction between

More information

Cryptogenic Organizing Pneumonia Diagnosis Approach Based on a Clinical-Radiologic-Pathologic Consensus

Cryptogenic Organizing Pneumonia Diagnosis Approach Based on a Clinical-Radiologic-Pathologic Consensus Cryptogenic Organizing Pneumonia Diagnosis Approach Based on a Clinical-Radiologic-Pathologic Consensus Poster No.: C-1622 Congress: ECR 2012 Type: Scientific Exhibit Authors: C. Cordero Lares, E. Zorita

More information

Imaging findings in Hypersensitivity Pneumonitis - a pictorical review.

Imaging findings in Hypersensitivity Pneumonitis - a pictorical review. Imaging findings in Hypersensitivity Pneumonitis - a pictorical review. Poster No.: C-1655 Congress: ECR 2014 Type: Educational Exhibit Authors: B. M. Araujo, A. F. S. Simões, M. S. C. Rodrigues, J. Pereira;

More information

Case Presentations in ILD. Harold R. Collard, MD Department of Medicine University of California San Francisco

Case Presentations in ILD. Harold R. Collard, MD Department of Medicine University of California San Francisco Case Presentations in ILD Harold R. Collard, MD Department of Medicine University of California San Francisco Outline Overview of diagnosis in ILD Definition/Classification High-resolution CT scan Multidisciplinary

More information

The Respiratory System. Dr. Ali Ebneshahidi

The Respiratory System. Dr. Ali Ebneshahidi The Respiratory System Dr. Ali Ebneshahidi Functions of The Respiratory System To allow gases from the environment to enter the bronchial tree through inspiration by expanding the thoracic volume. To allow

More information

Epidemiology and classification of smoking related interstitial lung diseases

Epidemiology and classification of smoking related interstitial lung diseases Epidemiology and classification of smoking related interstitial lung diseases Šterclová M. Department of Respiratory Diseases, Thomayer Hospital, Prague, Czech Republic Supported by an IGA Grant No G 1207

More information

Pulmonary manifestations of Rheumatoid Arthritis: what is there waiting to be found?

Pulmonary manifestations of Rheumatoid Arthritis: what is there waiting to be found? Pulmonary manifestations of Rheumatoid Arthritis: what is there waiting to be found? Poster No.: C-1795 Congress: ECR 2015 Type: Educational Exhibit Authors: M. S. C. Rodrigues, R. Correia, A. Carvalho,

More information

Restrictive lung diseases

Restrictive lung diseases Restrictive lung diseases Restrictive lung diseases are diseases that affect the interstitium of the lung. Interstitium of the lung is the very thin walls surrounding the alveoli, it s formed of epithelium

More information

Asthma. - A chronic inflammatory disorder which causes recurrent episodes of wheezing, breathlessness, cough and chest tightness.

Asthma. - A chronic inflammatory disorder which causes recurrent episodes of wheezing, breathlessness, cough and chest tightness. Obstructive diseases Asthma - A chronic inflammatory disorder which causes recurrent episodes of wheezing, breathlessness, cough and chest tightness. - Characterized by Intermittent and reversible (the

More information

A Review of Interstitial Lung Diseases. Paul J. Wolters, MD Associate Professor Department of Medicine University of California San Francisco

A Review of Interstitial Lung Diseases. Paul J. Wolters, MD Associate Professor Department of Medicine University of California San Francisco A Review of Interstitial Lung Diseases Paul J. Wolters, MD Associate Professor Department of Medicine University of California San Francisco Outline Overview of diagnosis in ILD Why it is important Definition/Classification

More information

INTERSTITIAL LUNG DISEASE. Radhika Reddy MD Pulmonary/Critical Care Long Beach VA Medical Center January 5, 2018

INTERSTITIAL LUNG DISEASE. Radhika Reddy MD Pulmonary/Critical Care Long Beach VA Medical Center January 5, 2018 INTERSTITIAL LUNG DISEASE Radhika Reddy MD Pulmonary/Critical Care Long Beach VA Medical Center January 5, 2018 Interstitial Lung Disease Interstitial Lung Disease Prevalence by Diagnosis: Idiopathic Interstitial

More information

Manish Powari Regional Training Day 10/12/2014

Manish Powari Regional Training Day 10/12/2014 Manish Powari Regional Training Day 10/12/2014 Large number of different types of Interstitial Lung Disease (ILD). Most are very rare Most patients present with one of a smaller number of commoner diseases

More information

Mimics in chest disease: interstitial opacities

Mimics in chest disease: interstitial opacities Insights Imaging (2013) 4:9 27 DOI 10.1007/s13244-012-0207-7 PICTORIAL REVIEW Mimics in chest disease: interstitial opacities Anastasia Oikonomou & Panos Prassopoulos Received: 19 June 2012 / Revised:

More information

A Place For Airway Clearance Therapy In Today s Healthcare Environment

A Place For Airway Clearance Therapy In Today s Healthcare Environment A Place For Airway Clearance Therapy In Today s Healthcare Environment Michigan Society for Respiratory Care 2015 Fall Conference K. James Ehlen, MD October 6, 2015 Objectives Describe patients who will

More information

THE MANY FACES OF PULMONARY TUMOR EMBOLISM

THE MANY FACES OF PULMONARY TUMOR EMBOLISM THE MANY FACES OF PULMONARY TUMOR EMBOLISM D Preciado, MD; E Castañer, MD; M Andreu, MD; X Gallardo, MD; I Costa, MD; V P Beltran, MD; B Consola, MD, J M Mata, MD,PhD. Department of Radiology, Section

More information

How to identify interstitial pneumonias.

How to identify interstitial pneumonias. How to identify interstitial pneumonias. Poster No.: C-0804 Congress: ECR 2014 Type: Educational Exhibit Authors: S. claret loaiza, M. C. Cañete Moslero, R. Carreño Gonzalez, C. de la Torre; Malaga/ES

More information

DISEASES OF THE RESPIRATORY SYSTEM 2018 DR HEYAM AWAD LECTURE 3: CHRONIC BRNCHITIS AND BRONCHIECTASIS

DISEASES OF THE RESPIRATORY SYSTEM 2018 DR HEYAM AWAD LECTURE 3: CHRONIC BRNCHITIS AND BRONCHIECTASIS DISEASES OF THE RESPIRATORY SYSTEM 2018 DR HEYAM AWAD LECTURE 3: CHRONIC BRNCHITIS AND BRONCHIECTASIS INTRDUCTION In the last lecture we discussed the difference between restrictive and obstructive lung

More information

I don t need you. Disclosure Statement. Pathology Approach to ILD 11/5/2016. Kirk D. Jones, MD UCSF Dept of Pathology

I don t need you. Disclosure Statement. Pathology Approach to ILD 11/5/2016. Kirk D. Jones, MD UCSF Dept of Pathology Pathology Approach to ILD Disclosure Statement Relevant financial relationships with a commercial interest: Boeringer Ingleheim, speaker Kirk D. Jones, MD UCSF Dept of Pathology kirk.jones@ucsf.edu I don

More information

Progress in Idiopathic Pulmonary Fibrosis

Progress in Idiopathic Pulmonary Fibrosis Progress in Idiopathic Pulmonary Fibrosis David A. Lynch, MB Disclosures Progress in Idiopathic Pulmonary Fibrosis David A Lynch, MB Consultant: t Research support: Perceptive Imaging Boehringer Ingelheim

More information

Downloaded from by on 01/23/18 from IP address Copyright ARRS. For personal use only; all rights reserved

Downloaded from  by on 01/23/18 from IP address Copyright ARRS. For personal use only; all rights reserved Downloaded from www.ajronline.org by 46.3.194.46 on 01/23/18 from IP address 46.3.194.46. Copyright RRS. For personal use only; all rights reserved sthma is an inflammatory disease of the lungs characterized

More information

Uses, limitations and interpretation of CT in pulmonary infections: A practical approach

Uses, limitations and interpretation of CT in pulmonary infections: A practical approach Uses, limitations and interpretation of CT in pulmonary infections: A practical approach Canadian Association of Radiologists 2013 DISCLOSURES Speakers honorarium, Siemens Canada Objectives 1. Recognize

More information

A Review of Interstitial Lung Diseases

A Review of Interstitial Lung Diseases Outline A Review of Interstitial Lung Diseases Paul J. Wolters, MD Associate Professor Department of Medicine University of California San Francisco Overview of diagnosis in ILD Why it is important Definition/Classification

More information

Imaging Spectrum of Allergic Lung Disease: Hypersensitivity Reactions on the Lung Parenchyma

Imaging Spectrum of Allergic Lung Disease: Hypersensitivity Reactions on the Lung Parenchyma Imaging Spectrum of Allergic Lung Disease: Hypersensitivity Reactions on the Lung Parenchyma Moon Sung Kim 1, Ki-Nam Lee 1, Won Jin Choi 1, Bo Ra Kim 1, Eun-Ju Kang 1 1 Department of Radiology, Dong-A

More information

ACUTE PULMNARY INFECTIONS: UNDERSTANDING THE CHEST RADIOGRAPH. Leonard E. Swischuk, M.D. University of Texas Medical Branch

ACUTE PULMNARY INFECTIONS: UNDERSTANDING THE CHEST RADIOGRAPH. Leonard E. Swischuk, M.D. University of Texas Medical Branch ACUTE PULMNARY INFECTIONS: UNDERSTANDING THE CHEST RADIOGRAPH Leonard E. Swischuk, M.D. University of Texas Medical Branch AUTHOR HAS NOTHING TO DECLARE LEARNING OBJETIVES Understand the pathophysiology

More information

Interstitial syndrome

Interstitial syndrome Interstitial syndrome Ground-glass attenuation Miliary and nodular images linear images Etienne Leroy Terquem Pierre L Her SPI / ISP Soutien Pneumologique International / International Support for Pulmonology

More information

Histopathologic Approach to Interstitial Lung Disease

Histopathologic Approach to Interstitial Lung Disease Histopathologic Approach to Interstitial Lung Disease Kirk D. Jones, MD UCSF Dept of Pathology kirk.jones@ucsf.edu Disclosures I have nothing to disclose 1 Why? Much of interstitial lung disease biopsies

More information

Resident Case Review CHEST. Daria Manos CAR 2016

Resident Case Review CHEST. Daria Manos CAR 2016 Resident Case Review CHEST CAR 2016 Daria Manos Disclosure Speakers bureau, Roche CAR 2016 Daria Manos 1. Recognize common and critical chest radiograph and computed tomography signs and use these clues

More information

10/17/2016. Nuts and Bolts of Thoracic Radiology. Objectives. Techniques

10/17/2016. Nuts and Bolts of Thoracic Radiology. Objectives. Techniques Nuts and Bolts of Thoracic Radiology October 20, 2016 Carleen Risaliti Objectives Understand the basics of chest radiograph Develop a system for interpreting chest radiographs Correctly identify thoracic

More information

Eun-Young Kang, M.D., Jae Wook Lee, M.D., Ji Yung Choo, M.D., Hwan Seok Yong, M.D., Ki Yeol Lee, M.D., Yu-Whan Oh, M.D.

Eun-Young Kang, M.D., Jae Wook Lee, M.D., Ji Yung Choo, M.D., Hwan Seok Yong, M.D., Ki Yeol Lee, M.D., Yu-Whan Oh, M.D. Eun-Young Kang, M.D., Jae Wook Lee, M.D., Ji Yung Choo, M.D., Hwan Seok Yong, M.D., Ki Yeol Lee, M.D., Yu-Whan Oh, M.D. Department of Radiology, Korea University Guro Hospital, College of Medicine, Korea

More information

Follicular bronchiolitis in surgical lung biopsies: Clinical implications in 12 patients

Follicular bronchiolitis in surgical lung biopsies: Clinical implications in 12 patients Respiratory Medicine (2008) 102, 307 312 Follicular bronchiolitis in surgical lung biopsies: Clinical implications in 12 patients Michelle R. Aerni a, Robert Vassallo a,, Jeffrey L. Myers b, Rebecca M.

More information

Diseases of the Lung and Respiratory Tract, Part I. William Bligh-Glover M.D. Department of Anatomy, CWRU

Diseases of the Lung and Respiratory Tract, Part I. William Bligh-Glover M.D. Department of Anatomy, CWRU Diseases of the Lung and Respiratory Tract, Part I William Bligh-Glover M.D. Department of Anatomy, CWRU Educational objectives: Distinguish the types of atelectasis and their etiologies Distinguish the

More information

Katerina M. Antoniou, MD, PhD As. Professor in Thoracic Medicine ERS ILD Group Secretary Medical School, University of Crete Prague, June 2014

Katerina M. Antoniou, MD, PhD As. Professor in Thoracic Medicine ERS ILD Group Secretary Medical School, University of Crete Prague, June 2014 Hypersensitivity pneumonitis: Causes, clinical course, diagnosis and differential diagnosis, treatment Katerina M. Antoniou, MD, PhD As. Professor in Thoracic Medicine ERS ILD Group Secretary Medical School,

More information

How to Analyse Difficult Chest CT

How to Analyse Difficult Chest CT How to Analyse Difficult Chest CT Complex diseases are:- - Large lesion - Unusual or atypical pattern - Multiple discordant findings Diffuse diseases are:- - Numerous findings in both sides 3 basic steps

More information

RESPIRATORY BLOCK. Bronchial Asthma. Dr. Maha Arafah Department of Pathology KSU

RESPIRATORY BLOCK. Bronchial Asthma. Dr. Maha Arafah Department of Pathology KSU RESPIRATORY BLOCK Bronchial Asthma Dr. Maha Arafah Department of Pathology KSU marafah@ksu.edu.sa Jan 2018 Objectives Define asthma (BA) Know the two types of asthma 1. Extrinsic or atopic allergic 2.

More information

Histopathology: pulmonary pathology

Histopathology: pulmonary pathology Histopathology: pulmonary pathology These presentations are to help you identify basic histopathological features. They do not contain the additional factual information that you need to learn about these

More information

Spectrum of Cystic Lung Disease and its Mimics. Kathleen Jacobs MD and Elizabeth Weihe MD UC San Diego Medical Center, Department of Radiology

Spectrum of Cystic Lung Disease and its Mimics. Kathleen Jacobs MD and Elizabeth Weihe MD UC San Diego Medical Center, Department of Radiology Spectrum of Cystic Lung Disease and its Mimics Kathleen Jacobs MD and Elizabeth Weihe MD UC San Diego Medical Center, Department of Radiology No Financial Disclosures Learning Objectives 1. Review the

More information

Diagnosis of TB: Radiology David Finlay, MD

Diagnosis of TB: Radiology David Finlay, MD TB Intensive Tyler, Texas June 2-4, 2010 Diagnosis of TB: Radiology David Finlay, MD June 3, 2010 2stages stages- Tuberculosis 1. primary infection 2. reactivation, or post primary disease 2 1 Primary

More information

The Respiratory System

The Respiratory System The Respiratory System Respiratory Anatomy Upper respiratory tract Nose Nasal passages Pharynx Larynx Respiratory Anatomy Functions of the upper respiratory tract: Provide entry for inhaled air Respiratory

More information

Daria Manos RSNA 2016 RC 401. https://medicine.dal.ca/departments/depar tment-sites/radiology/contact/faculty/dariamanos.html

Daria Manos RSNA 2016 RC 401. https://medicine.dal.ca/departments/depar tment-sites/radiology/contact/faculty/dariamanos.html Daria Manos RSNA 2016 RC 401 https://medicine.dal.ca/departments/depar tment-sites/radiology/contact/faculty/dariamanos.html STEP1: Is this fibrotic lung disease? STEP 2: Is this a UIP pattern? If yes:

More information

Pulmonary Patterns & Correlated Pathology

Pulmonary Patterns & Correlated Pathology Pulmonary Patterns & Correlated Pathology Russell Tucker, DVM, DACVR Washington State University College of Veterinary Medicine Objective: correlate radiographic findings of common lung diseases to actual

More information

Chapter 10 The Respiratory System

Chapter 10 The Respiratory System Chapter 10 The Respiratory System Biology 2201 Why do we breathe? Cells carry out the reactions of cellular respiration in order to produce ATP. ATP is used by the cells for energy. All organisms need

More information

Parametric response mapping

Parametric response mapping Parametric response mapping Utility of a novel imaging biomarker in pulmonary disease Dharshan Vummidi MD, Lama VN MD, Yanik G MD, Kazerooni EA MD, Meilan Han MD, Galban C PhD Radiology, Pulmonary & Critical

More information

TB Radiology for Nurses Garold O. Minns, MD

TB Radiology for Nurses Garold O. Minns, MD TB Nurse Case Management Salina, Kansas March 31-April 1, 2010 TB Radiology for Nurses Garold O. Minns, MD April 1, 2010 TB Radiology for Nurses Highway Patrol Training Center Salina, KS April 1, 2010

More information

Case 1: Question. 1.1 What is the main pattern of this HRCT? 1. Intralobular line 2. Groundglass opacity 3. Perilymphatic nodule

Case 1: Question. 1.1 What is the main pattern of this HRCT? 1. Intralobular line 2. Groundglass opacity 3. Perilymphatic nodule HRCT WORK SHOP Case 1 Case 1: Question 1.1 What is the main pattern of this HRCT? 1. Intralobular line 2. Groundglass opacity 3. Perilymphatic nodule Case 1: Question 1.2 What is the diagnosis? 1. Hypersensitivity

More information

Pulmonary Manifestations of Systemic Lupus Erythematosus 1

Pulmonary Manifestations of Systemic Lupus Erythematosus 1 Pulmonary Manifestations of Systemic Lupus Erythematosus 1 Kee Hyuk Yang, M.D., Yo Won Choi, M.D., Seok Chol Jeon, M.D., Choong Ki Park, M.D., Kyung in Joo, M.D., Chang Kok Hahm, M.D., Seung Ro Lee, M.D.

More information