Diffuse Lung Disease

Question 1

What is seen on CXR of chronic alveolar disease?

Answer 1

• Bilateral white out of lungs.
• Butterfly distribution of density.
• Air bronchogram in both bases.

Question 2

What are the differential diagnoses of chronic alveolar disease?

Answer 2

• Alveolar proteinosis
• Desquamative interstitial disease
• Alveolar form of lymphoma
• Mineral oil aspiration
• Alveolar cell carcinoma

Question 3

What is seen on CXR of acute alveolar disease?

Answer 3

• Bilateral white out of lungs
• Medullary (butterfly) distribution
• Soft fluffy densities coalescing with each other
• Air bronchogram

Question 4

What are the differential diagnoses for acute alveolar disease?

Answer 4

• Pulmonary edema
• ARDS
• Pulmonary hemorrhage
• Pneumonias: Influenza, pneumocystis

Question 5

What are some of the features of interstitial lung disease?

Answer 5

• Lines: Kerley lines
• Nodules
• Honeycombing

Question 6

What is the differential diagnosis for a diffuse reticulonodular (lines) pattern?

Answer 6

• Silicosis
• Lymphangitic spread
• Idiopathic interstitial fibrosis

Question 7

What is the differential diagnosis for military nodules?

Answer 7

• Miliary tuberculosis
• Sarcoidosis
• Silicosis
• Eosinophilic granuloma

Question 8

What is the differential diagnosis for honeycombing of the lungs?

Answer 8

• Scleroderma: Presents with honeycombing in bases of lungs.
• Eosinophilic granuloma: Honeycombing in the upper lung fields.
• End stage interstitial disease

Question 9

What is the difference between alveolar and interstitial patterns?

Answer 9

Alveolar - diffuse white out of the lungs

Interstitial - dirty lungs (lines, military nodules, honey combing)