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Fig. 8 | Insights into Imaging

Fig. 8

From: The crazy-paving pattern: a radiological-pathological correlation

Fig. 8

Lymphangitic carcinomatosis. a Chest radiograph showed a pleural effusion in the right haemothorax. An increased linear pattern was seen in the left and right upper lung. b CT showed a diffuse crazy-paving pattern with areas of ground-glass attenuation and thickening of the interlobular septa (1). There were also some small nodular lesions visible mostly in the left upper lobe suggestive of pulmonary metastases (2). c Radiological-histopathological correlation. Histological examination of the autopsy specimen demonstrated thickening of the interlobular septa (*) due to fibrosis and the presence of tumour cells. There was also perivascular (arrow) thickening due to an expansion of lymphatic spaces by tumour cells. The histological reaction was that of diffuse alveolar damage and consisted of hyaline membranes in the alveolar ducts and respiratory bronchioles while the alveolar spaces fill with an exudate of proteinaceous material. This corresponded to the ground-glass opacities on CT. The reticular pattern was due to congestion of capillaries and oedema of the interstitium

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