Radiologic-pathologic correlation of pulmonary diseases

Transcription

1 The 1578 th Chest Conference/ 3 rd Biennial Clinical- Radiologic-Pathologic Correlation Radiologic-pathologic correlation of pulmonary diseases Harumi Itoh, M.D. University of Fukui, Japan

2 Centriacinar emphysema 1 Centriacinar emphysema 2 Centriacinar emphysema 3 ILS Paraseptal normal lung Interlobular septum Centrilobular normal lung Paraseptal normal lung with polygonal shape onchopneumonia 4 onchopneumonia (centrilobular nodule) 5 Pulmonary tuberculosis R 6 Cavity MB Small nodules Respiratory bronchiole Multiple nodules 1 mm 1

3 Pulmonary tuberculosis (centrilobular loose nodules) 7 Pulmonary tuberculosis 8 Centrilobular cavity Pulmonary tuberculosis (centrilobular compact nodules) 9 3 mm ILS onchiole 2 mm Pulmonary tuberculosis (centrilobular nodules) 10 Pulmonary tuberculosis (centrilobular nodules) 11 Pulmonary tuberculosis (tree in bud) mm 3 mm.... slice3 2

4 Pulmonary tuberculosis (tree in bud) 13 Silicosis (centrilobular nodules) Interlobular septum 14 Silicosis (centrilobular compact nodule) 15 5mm 3mm Silicosis (centrilobular small nodule) 16 Silicosis (paraseptal nodule) 17 Silicosis (paraseptal nodule) 18 Centrilobular nodule 1mm 5mm 1mm 3

5 Silicosis 19 Silicosis Calcified nodules 20 Silicosis (centrilobular nodule) 21 Left upper lobe Centrilobular Focal emphysema onchiole Paraseptal Pleura Interlobular septum 5mm Centrilobular nodule Interlobular septum 1mm Silicosis (centrilobular + paraseptal nodules) 22 Langerhans cell histiocytosis 23 Langerhans cell histiocytosis 24 Centrilobular nodules 5 mm Centrilobular cysts 4

6 IPF/UIP Courtesy of Dr. T. Takemura, Japan 25 IPF/UIP mm f-nsip 27 RB ILS RB * MB Subpleural small opacities Perilobular, periacinar fibrosis (fibrosis of alveoli along pulmonary venules) Courtesy of Dr. T. Ogura, Japan mm Courtesy by Dr. T. Takemura, Japan SSc R Polygonal opacities 28 IPF/UIP (honeycomb lung) 29 Honeycomb lung (IPF/UIP) 30 ILS 2mm MB 10mm N Traction bronchiectasis Courtesy by Dr. T. Ogura, Japan 2 cm 2 cm 10mm Courtesy by Dr. T. Takemura, Japan 5

7 Honeycomb lung(ipf/uip) 31 Pulmonary fibrosis combined with emphysema Courtesy of Dr. T. Ogura, Japan 32 Pulmonary fibrosis combined with emphysema 33 Cystic change with destruction of respiratory bronchioles and alveoli A A MB * Perilobular fibrosis along and pleura V * V * * in emphysematous space A years later 160 Courtesy of Dr. T. Takemura Pulmonary edema (left heart failure) 34 Pulmonary edema 35 Pulmonary edema 36 Short septal lines in lung base 1cm thickened interlobular septum and pleura Short septal lines 3cm 6

8 Centilobular nodules Pulmonary ossification 37 Thickened long septa Normal long septa 38 Lymphangiosis carcinomatosa 39 ILS Coronal CT Thickened pleura Thickened bronchoarterial bundle ILS Thickened interlobular septum 3mm 3mm Left upper lobe Lymphangiosis carcinomatosa 40 Lymphangiosis carcinomatosa 41 Lymphangiosis carcinomatosa 42 Thickened bronchovascular bundles (central and periphery) Thickened bronchoarterial bundle Thickened interlobular septum 2mm 7

9 Lymphoproliferative disorder 43 Lymphoproliferative disorder 44 Pulmonary sarcoidosis 45 onchovascular bundle onchovascular bundle Thickening of centrilobular bronchovascular bundles Y.S Pulmonary sarcoidosis 46 Pulmonary sarcoidosis 47 Pulmonary sarcoidosis 48 2mm 8

10 Pulmonary sarcoidosis 49 Pulmonary sarcoidosis 50 Pulmonary thromboembolism 51 RB Pulmonary thromboembolism 52 Metastasis of hepatic cancer 53 Metastasis of hepatic cancer 54 Pulmonary artery Pulmonary arteries onchiole 2 5 mm Pulmonary vein 9

11 Metastasis of hepatic cancer 55 Cystic metastasis of bladder cancer 56 Metastasis of bladder cancer 57 Pulmonary artery: filled by tumor and thrombus onchiole Pulmonary artery: dilated with tumors 1 mm 1 Thickened blood vessels Courtesy of Dr. S. Imokawa 2 66 Perivascular tumor 1mm Courtesy of Dr. S. Imokawa Org. DAD 58 Org. DAD 59 Adenocarcinoma 60 Traction bronchiectsis Ground glass shadow Thickened back to back alveoli AD AD 1 mm Thickened back to back alveoli intervened by contrasted air space K.T 10

12 Adenocarcinoma Adenocarcinoma with lepidic growth 61 GGA Thickened back-to-back alveoli Normal back-to-back alveoli 11