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 pneumonitis 2. Silicosis 3. Alveolar proteinosis 4. Miliary tuberculosis
Case 2
Case 2 : Question 2.1 What is the main pattern of this HRCT? 1. Nodule 2. Groundglass opacity 3. Reticular line
Case 2 : Question 2.2 What is the intralobular distribution? 1. Centrilobular 2. Perilymphatic 3. Random
Case 2 : Question 2.3 What is the diagnosis? 1. Hypersensitivity pneumonitis 2. Silicosis 3. Lymphangitic carcinomatosis 4. Miliary tuberculosis
Case 3
Case 3 : Question 3.1 What about the lung volume? 1. Increase 2. Normal 3. Decrease
Case 3 : Question 3.2 What is the intralobular distribution? 1. Centrilobular 2. Perilymphatic 3. Random
Case 4
Case 4: Question 4.1 What is the intralobular distribution? 1. Centrilobular 2. Perilymphatic 3. Random
Case 4: Question 4.2 What is the associated finding? 1. Bronchiectasis 2. Lymphadenopathy 3. Pleural effusion
Case 4: Question 4.3 What is the diagnosis? 1. Bronchial spreading tuberculosis 2. Miliary tuberculosis 3. Lymphangitic carcinomatosis
Case 5
Case 5: Question 5.1 What is the main pattern of this HRCT? 1. Micronodule 2. Line 3. Both 1 and 2
Case 5: Question 5.2 What is the intralobular distribution? 1. Centrilobular 2. Perilymphatic 3. Random
Case 6
Case 6: Question 6.1 What is this CT sign? 1. Crazy paving 2. Mosaic pattern
Case 7
Case 7: Question 7.1 What is the craniocaudal distribution? 1. Upper + middle 2. Lower + middle 3. Diffuse
Case 7: Question 7.2 What is the diagnosis? 1. Emphysema 2. Langerhans cell histocytosis (LCH) 3. Lymphangiomyomatosis (LAM)
Case 8
Case 8: Question 8.1 What is the main pattern of this HRCT? 1. Honeycomb 2. Groundglass opacity 3. Consolidation
Case 9
Case 9: Question 9.1 What is the diagnosis? 1. Emphysema 2. Langerhans cell histocytosis(lch) 3. Lymphangiomyomatosis (LAM)
Case 10
Case 10: Question 10.1 What is the main pattern of this HRCT? 1. Smooth septal thickening 2. Nodular septal thickening 3. Centrilobular nodule
Case 10: Question 10.2 What is the associated finding? 1. Pleural effusion 2. Pulmonary arterial hypertension 3. Lymphadenopathy
Case 11
Case 11: Question 11.1 What is the main pattern of this HRCT? 1. Smooth interlobular septal thickening 2. Nodule 3. Ground glass opacity
Case 11: Question 11.2 What is the pattern of disease spreading? 1. Perilymphatic spreading 2. Bronchial spreading
Case 11: Question 11.3 What is the associated finding? 1. Pleural effusion 2. Enlarged lymph node 3. 1 and 2
Case 11: Question 11.4 What is the diagnosis? 1. PAP 2. Hypersensitivity pneumonitis 3. Lymphangitic carcinomatosis
Case11 : Question 11.5 What is the best further investigation? 1. Surgical Bx 2. Thoracoscopic Bx 3. Bronchoscopic BX
Case 12
Case12 : Question 12.1 What is the main pattern of this HRCT? 1. Interlobular line 2. Intralobular line 3. GGO
Case 12 : Question 12.2 What is the axial distribution? 1. Peripheral 2. Central 3. Diffuse
Case 12 : Question 12.3 What is the intralobular distribution? 1. Perilobular 2. Centrilobular 3. Panlobular
Case 13
Case 13 : Question 13.1 What about the lung volume? 1. Increase 2. Normal 3. Decrease
Case 13 : Question 13.2 What is the main pattern of this HRCT? 1. Reticulation 2. Nodule 3. Honeycombing
Case 13 : Question 13.3 What is the craniocaudal distribution? 1. Upper 2. Diffuse 3. Lower
Case 13 : Question 13.4 What is the axial distribution? 1. Peripheral 2. Diffuse 3. Central
Case 13 : Question 13.5 What is the intralobular distribution? 1. Perilobular 2. Centrilobular 3. Panlobular
Case 14
Case 14 : Question 14.1 What is the main pattern of this HRCT? 1. Reticulation 2. Groundglass opacity 3. Honeycombing
Case 14 : Question 14.2 What is the craniocaudal distribution? 1. Upper 2. Diffuse 3. Lower
Case 14 : Question 14.3 What is the axial distribution? 1. Peripheral 2. Diffuse 3. Central
Case 14 : Question 14.4 What is the intralobular distribution? 1. Panlobular 2. Centrilobular 3. Perilobular
Case 14 : Question 14.5 A patient known to have systemic sclerosis for 5 years develops dry cough, dyspnea on exertion and shortness of breath. What is the proper management? 1. Surgical biopsy 2. Pulmonary function test 3. Bronchoscopic biopsy
Case 15
Case 15 : Question 15.1 What is the main pattern of this HRCT? 1. Groundglass opacity 2. Nodule 3. Reticulation
Case 15 : Question 15.2 What is the most likely diagnosis? 1. BOOP 2. Lymphoma 3. NSIP
Case 15 : Question 15.3 What is the best further management? 1. Bronchoscopic biopsy 2. Surgical biopsy 3. Steroid
Case 16
Case 16: Question 16.1 What is the main pattern of this HRCT? 1. Groundglass opacity 2. Nodule 3. reticulation
Case 16: Question 16.2 What is the craniocaudal distribution? 1. Upper 2. Diffuse 3. Lower
Case 16 : Question 16.3 What is the axial distribution? 1. Peripheral 2. Diffuse 3. Central
Case 17
Case 17 : Question 17.1 What about the lung volume? 1. Increased 2. Normal 3. Decreased
Case 17 : Question 17.2 What is the axial distribution? 1. Peripheral 2. Diffuse 3. Central
Case 17 : Question 17.3 What is the intralobular distribution? 1. Perilymphatic 2. Centrilobular 3. Random
Case 18
Case 18 : Question 18.1 What is the main pattern of this HRCT? 1. Ground glass opacity 2. Septal thickening 3. 1 and 2
Case 18: Question 18.2 What is the craniocaudal distribution? 1. Upper 2. Diffuse 3. Lower
Case 18: Question 18.3 What is the axial distribution? 1. Peripheral 2. Diffuse 3. Central
Case 18 : Question 18.4 What is intralobular distribution? 1. Perilymphatic 2. Centrilobular 3. Random
Case 18 : Question 18.5 What is the associated finding? 1. Lymph node enlargement 2. Lung mass 3. Pleural thickening
Case 18 : Question 18.6 What is the diagnosis? 1. Lymphangitic carcinomatosis 2. Pulmonary alveolar proteinosis 3. Pulmonary edema
Case 19
Case 19 : Question 19.1 What is the main pattern of this HRCT? 1. Ground glass opacity 2. Ill-defined nodule 3. 1. and 2.
Case 19: Question 19.2 What is the axial distribution? 1. Peripheral 2. Diffuse 3. Central
Case 19 : Question 19.3 What is the intralobular distribution? 1. Perilymphatic 2. Centrilobular 3. Random
Case 19 : Question 19.4 What is the diagnosis? 1. Hypersensitivity pneumonitis 2. NSIP 3. PAP
Case 20
Case 20 : Question 20.1 What is the main pattern of this HRCT? 1. Nodule 2. Ground glass opacity 3. Septal thickening 4. 2 and 3.
Case 20 : Question 20.2 What is the distribution of this HRCT in axial view? 1. Peripheral 2. Diffuse 3. Central
Case 20 : Question 20.3 What is the intralobular distribution? 1. Perilymphatic 2. Centrilobular 3. Random
Case 20: Question 20.4 What is the associated finding? 1. Lymph node enlargement 2. Pericardial thickening 3. 1. and 2.
Case 20: Question 20.5 What is the diagnosis? 1. Lymphangitic carcinomatosis 2. PAP 3. Pulmonary edema
Suspected diffused lung disease Chest radiograph Normal or equivocal Abnormal Suggestive of sarcoidosis HRCT with prone views HRCT Trans bronchial Bx Normal Abnormal See next slide Bx if clinical/physiologic evidence of disease See next slide
Suspected diffused lung disease Specific CT pattern(uip,eg,lam,h P, Lipoid Pneumonia) CT pattern suggestive of HP sarcoid, lymphagitic carcinoma,pap, alveolar carcinoma,eosinophillic pneumonia, BOOP Other CT pattern Accept CT diagnosis if clinical scenario is consistent Trans bronchial biopsy and/or brochoalveolar lavage (CT directed) Thoracosopic biopsy (CT directed)
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