Case 5


Section 1

Image 1

1. What are the major abnormalities in this case?

a) Nodules
b) Linear opacities
c) Consolidation
d) Ground-glass opacity

2. Which lung is involved?

a) Left
b) Right
c) Both

Answers

lobule1lobule2bvbundleils

What is the distribution of the lesions?

a) Bronchovascular interstitium
b) Interlobular septa
c) Centrilobular region
d) Pleura

Answer


Section 2

Image 1

 

Find multiple, connected, thickened interlobular septa in the right lung.

Find an example of thickened bronchovascular interstitium in the right lung.

Find 2 examples of polygonal lobules with centrilobular nodules in the right lung.

lobule1lobule2bvbundleils

Image 2

 

Find the thickened fissural pleura in the right lung.

Find 2 lobules with thickened interlobular septa and centrilobular nodules in the right lung.

Find an example of thickened bronchovascular interstitium in the right lung.

pleuralobule1lobule2bvbundle

Differential diagnosis of thickened bronchovascular, interlobular septal, and pleural interstitium on HRCT: Lymphangitic tumor, lymphoma, Kaposi's sarcoma, and edema. The unilaterality would be very unusual for Kaposi's sarcoma or edema.

Diagnosis: Lymphangitic tumor

Review of gross and histologic findings in lymphangitic tumor (Remember to use the "back" button in the menu bar to return.)

Summary of diagnostic features of lymphangitic tumor on HRCT

Comment: Unilateral lymphangitic tumor is most commonly seen in cases of primary pulmonary adenocarcinoma, as in this case.

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1. a. & b. Nodules and linear opacities

2. b. Only the right lung is involved

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All are correct: bronchovascular interstitium, interlobular septa, centrilobular region, and pleura

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Polygonal lobule with centrilobular nodule

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Multiple, connected, thickened interlobular septa. Outline them.

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Thickened bronchovascular interstitium

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Thickened bronchovascular interstitium

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Lobule with centrilobular nodule

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Thickened fissural pleura

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