Computed Tomography of the Lung A Pattern Approach by Johny A. Verschakelen, Walter De Wever

By Johny A. Verschakelen, Walter De Wever

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De Wever a Fig. 10. Acute interstitial pneumonia. Ground-glass opacity is associated with linear opacities, creating a crazy-paving pattern b Fig. 9a,b. Usual interstitial pneumonia in a patient with systemic sclerosis. a The dominant pattern is ground-glass opacity, which is located in the dorsal and basal subpleural region of both lungs, suggesting active lung disease. However, at the basal slice (b), there is some irregular interstitial thickening together with some bronchial distortion (arrow), suggesting the presence of fibrosis in that part of the lung Fig.

15). When sharply defined, airspace fi lling by tissue (tumour, granulation tissue) is suggested (Fig. 16), when blurred airspace fi lling by fluid or cells may be the cause (Fig. 15). Similar to ground-glass opacity, to make the differential diagnosis of lung consolidation, it is also very important to know whether the patient’s symptoms are acute, subacute or chronic. Since airspace fi lling is the most frequent cause of lung consolidation, this pattern is often associated with the presence of centrilobular airspace nodules corresponding with early airspace fi lling, as is often seen in diseases that show a bronchial distribution (Fig.

1991; Helbich et al. 1997; Korn et al. 1992). Disseminated ossification is a rare condition in which very small deposits of mature bone form within the lung parenchyma and can be associated with chronic heart disease (mitral stenosis), idiopathic pulmonary fibrosis (IPF) or asbestosis (Gevenois et al. 1994). Finally, the drug amiodarone can accumulate in the lung and is in some patients responsible for a pulmonary toxic reaction with interstitial pneumonia and fibrosis. The consolidated lung parenchyma may appear abnormally dense.

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