Interpretation of lung pathology mma kareem-edu publish

MMA Kareem, USM, KB, Malaysia-EduPublish

INTERPRETATION OF LUNG PATHOLOGY

Prof Madya Dr. Hj. M. Abdul Kareem ©Universiti Sains Malaysia


Interpretation of Pathology

Pulmonary disorders can be detected on CXR because of the difference in the radiographic density between the normally aerated lung and the diseased lung.


ABNORMAL OPACITIES ON CXR

*Consolidation*Collapse (atelectasis)

*Nodules/ masses*Interstitial opacities*Free or loculated pleural fluid*Ring-cavitary/cystic


CONSOLIDATION

- It is due to the replacement of air in the distal airways and alveoli by fluid (transudate, exudate including eosinophilic exudate, blood) or rarely tissue/ tumour cells without destroying the lung parenchyma.

- Consolidation produces an area of increased radio-opacity


Streptococcus pneumoniae pneumonia-community acquired

Streptococcus pneumoniae pneumonia


MMA Kareem, USM, KB, Malaysia-EduPublishPTB


Ac. Pulmonary oedema –alveolar pattern


Interstitial Pneumonitis

http://www.e-radiography.net/ibase5/Chest_Pulmonary/Chest_pneumonitis_interstitial_2.jpg


COLLAPSE / ATELACTASIS

A consequent of the airway obstruction (main stem, lobar or a segmental) by an intraluminal, mural or an extramural lesions.

Air in the lung distal to the obstruction is gradually reabsorbed by the pulmonary circulation.

Radiographically causes a homogenous opacity


Rt upper lobe collapse

minor fissure pulled upward


Triangular opacity of upper lobe collapse


Rt middle lobe collapse seen as a wedge shape opacity


Rt LL collapse causing increase opacity over the lower thoracic spine


NODULAR OPACITY/MASSES

well defined opacities –d/t infiltration of foreign substance or pathogen or tumour cells into the alveolar/interstitium

essentially “spherical” in shape may be single or multiple variable in sizes Masses -nodules that are more

than 3 cm in diameter Miliary nodules -multiple small

nodules about 0.5- 2mm in diameter


Rt hilar mass-Bronchogenic Ca


Solitary pulmonary mass-eroding the posterior 8th rib




Lt Hilar mass



Terratodermoid tumor

http://www.e-radiography.net/ibase5/Chest_Pulmonary/Chest_teratodermoid_cyst.jpg


Mediastinal mass

http://in.wrs.yahoo.com/_ylt=As7rxYocWCweRbwuen5UmrS9HAx.;_ylu=X3oDMTBqaXBrN2duBHBvcwMzNwRzZWMDc3IEdnRpZAM-/SIG=1gim7g2b4/**http%3A/in.images.search.yahoo.com/search/images/view%3Fback=http%253A%252F%252Fin.images.search.yahoo.com%252Fsearch%252Fimages%253Fp%253Dchest%252Bx-ray%2526toggle%253D1%2526ei%253DUTF-8%2526fr%253DFP-tab-%25255Bobject%252BObject%25255D-t909%2526b%253D21%26w=275%26h=302%26imgurl=www.acponline.org%252Fbioterro%252Fchest_xray.jpg%26rurl=http%253A%252F%252Fwww.acponline.org%252Fbioterro%252Fchest_xray.htm%26size=11.1kB%26name=chest_xray.jpg%26p=chest%2Bx-ray%26type=jpeg%26no=37%26tt=6,762%26oid=f98bb73e9cfd8dd0%26ei=UTF-8


Multiple pulmonary masses-Metastases


Multiple pulmonary Metastases-chorioCa


Milliary nodules-Milliary TB


RING-CYSTIC /CAVITARY OPACITIES

Annular opacities with a central transradiancy / lucency

due to cavitation (necrosis) of a nodule, mass or consolidation

http://in.wrs.yahoo.com/_ylt=As7rxYocWCweRbwuen5UmrS9HAx.;_ylu=X3oDMTBqaXBrN2duBHBvcwMzNwRzZWMDc3IEdnRpZAM-/SIG=1gim7g2b4/**http%3A/in.images.search.yahoo.com/search/images/view%3Fback=http%253A%252F%252Fin.images.search.yahoo.com%252Fsearch%252Fimages%253Fp%253Dchest%252Bx-ray%2526toggle%253D1%2526ei%253DUTF-8%2526fr%253DFP-tab-%25255Bobject%252BObject%25255D-t909%2526b%253D21%26w=275%26h=302%26imgurl=www.acponline.org%252Fbioterro%252Fchest_xray.jpg%26rurl=http%253A%252F%252Fwww.acponline.org%252Fbioterro%252Fchest_xray.htm%26size=11.1kB%26name=chest_xray.jpg%26p=chest%2Bx-ray%26type=jpeg%26no=37%26tt=6,762%26oid=f98bb73e9cfd8dd0%26ei=UTF-8



PTB

http://www.e-radiography.net/ibase5/Chest_Pulmonary/Chest_tb_calcification.jpg

http://www.e-radiography.net/ibase5/Chest_Pulmonary/Chest_tb_cavitation.jpg


Ct thorax-cystic bronchiectasis


PLEURAL OPACITY

Pleural effusion: fluid within the pleural cavity

Pleural based mass- obtuse angle with the lung parenchyma


MMA Kareem, USM, KB, Malaysia-EduPublishPleural effusion-meniscus sign


Pleural based mass


ABNORMAL TRANSRADIANCY/LUCENCY

1) Bullous emphysema- destruction of the lung parenchyma and forms a structureless air sac

2) Pneumothorax: air within the pleural cavity


MMA Kareem, USM, KB, Malaysia-EduPublishFocal bullous emphysema

MMA Kareem, USM, KB, Malaysia-EduPublishCt thorax-Focal bullous emphysema

MMA Kareem, USM, KB, Malaysia-EduPublishLt tension pneumothorax


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Interpretation of lung pathology mma kareem-edu publish