- Pictorial Review
- Open Access
Mimics in chest disease: interstitial opacities
© The Author(s) 2012
- Received: 19 June 2012
- Accepted: 16 November 2012
- Published: 18 December 2012
Septal, reticular, nodular, reticulonodular, ground-glass, crazy paving, cystic, ground-glass with reticular, cystic with ground-glass, decreased and mosaic attenuation pattern characterise interstitial lung diseases on high-resolution computed tomography (HRCT). Occasionally different entities mimic each other, either because they share identical HRCT findings or because of superimposition of patterns. Idiopathic pulmonary fibrosis (IPF), fibrosis associated with connective tissue disease, asbestosis, end-stage sarcoidosis or chronic hypersensitivity pneumonitis (HP) may present with lower zone, subpleural reticular pattern associated with honeycombing. Lymphangiomyomatosis may be indistinguishable from histiocytosis or extensive emphysema. Both pulmonary oedema and lymphangitic carcinomatosis may be characterised by septal pattern resulting from thickened interlobular septa. Ill-defined centrilobular nodular pattern may be identically present in HP and respiratory bronchiolitis–associated with interstitial lung disease (RBILD). Sarcoidosis may mimic miliary tuberculosis or haematogenous metastases presenting with miliary pattern, while endobronchial spread of tuberculosis may be indistinguishable from panbronchiolitis, both presenting with tree-in-bud pattern. Atypical infection presenting with ground-glass mimics haemorrhage. Ground-glass pattern with minimal reticulation is seen in desquamative interstitial pneumonia (DIP), RBILD and non-specific interstitial pneumonia (NSIP). Obliterative bronchiolitis and panlobular emphysema may present with decreased attenuation pattern, while obliterative bronchiolitis, chronic pulmonary embolism and HP may manifest with mosaic attenuation pattern. Various mimics in interstitial lung diseases exist. Differential diagnosis is narrowed based on integration of predominant HRCT pattern and clinical history.
• To learn about the different HRCT patterns, which are related to interstitial lung diseases.
• To be familiar with the more “classical” entities presenting with each HRCT pattern.
• To discuss possible overlap of different HRCT patterns and the more common mimics in each case.
• To learn about some clues that help differentiate the various diagnostic mimics on HRCT.
- Interstitial lung diseases
- HRCT patterns
- Ground-glass opacity
Since the advent of high-resolution computed tomography (HRCT) in the 1990s the understanding of interstitial lung disease has dramatically changed. As CT descriptions of the various diffuse lung diseases are being continuously refined and certain CT characteristics are considered pathognomonic while others become less specific, HRCT finds its role in an integrated approach of diagnosis where it provides sufficient information to produce a differential diagnosis and in many cases allows a non-invasive definitive diagnosis .
There are various patterns of interstitial lung disease on HRCT, each one representing different interstitial lung diseases with completely different histological appearances and clinical manifestations. The main distinct interstitial HRCT patterns are five: septal, reticular, nodular, cystic, ground-glass and decreased lung attenuation pattern. Although each HRCT pattern encompasses many different interstitial lung entities, the contrary may also occur, namely one entity may present with many different patterns and have many different “faces”. To make things even more complicated, there may be overlap of HRCT patterns in one entity. In everyday clinical practice one should try to combine the different HRCT patterns or identify the predominant pattern in order to make the correct diagnosis [2, 3]. Integration of HRCT findings with clinical findings and the knowledge of acute or chronic symptoms is crucial to reach the correct diagnosis.
HRCT patterns and differential diagnosis of interstitial lung diseases
DIFFERENTIAL DIAGNOSIS OF DISEASES
Hydrostatic pulmonary oedema, lymphangitic carcinomatosis, sarcoidosis, Niemann-Pick disease, Erdheim-Chester disease, cystic lymphangiectasia, pulmonary lymphangiomatosis
IPF, NSIP, asbestosis, chronic HP, rheumatoid arthritis, DIP, end-stage sarcoidosis
Subacute HP, RBILD, DIP, Pneumocystis pneumonia
Crazy paving pattern
Alveolar proteinosis, Pneumocystis pneumonia, exogenous lipoid pneumonia, sarcoidosis, diffuse alveolar haemorrhage, viral/opportunistic infection, invasive mucinous adenocarcinoma
Mixed GGO and reticular
NSIP, scleroderma, IPF, DIP
Haematogenous metastases, miliary infection
Sarcoidosis, silicosis, coal workers pneumoconiosis
silicosis, coal workers pneumoconiosis
Panbronchiolitis, tuberculosis, atypical mycobecteria infection, metastatic tumour emboli
Subacute HP, RBILD, cryptogenic organising pneumonia, lymphocytic interstitial pneumonia, follicular bronchiolitis
Sarcoidosis, berylliosis, lymphangitic carcinomatosis
Lymphangioleiomyomatosis, pulmonary histiocytosis, lymphocytic interstitial pneumonia, centrilobular emphysema
Mixed Cystic and GGO
Pneumocystis pneumonia, lymphocytic interstitial pneumonia, subacute HP, DIP
Obliterative bronchiolitis, panlobular emphysema
Obliterative bronchiolitis, chronic thromboembolic pulmonary hypertension, subacute HP, RBILD
For the easier approach to this review by the reader, we describe a “classic” entity and the various “mimics” for each HRCT pattern. The “classic” entity is selected in an arbitrary way either because it may be the most representative and commonly one reported for the specific HRCT pattern or because it may be the entity for which, the specific HRCT pattern was initially described.
Septal pattern is defined as thickening of the interlobular septae (i.e. the borders of the secondary pulmonary lobules). Normally very few interlobular septae are seen in the anterior and lower aspects of the lower lobes on HRCT. Thickened interlobular septae are demonstrated as short lines extending perpendicularly to the peripheral pleura or the fissures, or as polygonal arcades surrounding secondary pulmonary lobules more centrally. Septal thickening can be smooth, nodular or irregular .
There are many “mimics” of the septal pattern: lymphangitic carcinomatosis, sarcoidosis and Niemann-Pick disease, Erdheim-Chester disease, cystic lymphangiectasia and occasionally pulmonary fibrosis.
On HRCT, reticular pattern is characterised by innumerable interlacing shadows suggesting a mesh. The constituents of the reticular pattern may be all or some of the following: interlobular septal thickening, intralobular interstitial thickening, wall cysts of honeycombing, peribronchovascular interstitial thickening and traction bronchiectasis/bronchiolectasis .
The prototype entity for reticular pattern is idiopathic pulmonary fibrosis, which is characterised by subpleural and posterior predominance of intralobular interstitial thickening, traction bronchiectasis/bronchiolectasis, irregular interlobular septal thickening and honeycombing. Areas of ground-glass opacity associated with bronchiectasis and bronchiolectasis may also coexist, but areas of pure ground-glass opacity are extremely rare.
The major mimics of idiopathic pulmonary fibrosis and therefore of reticular pattern are non-specific interstitial pneumonia (NSIP), asbestosis, chronic hypersensitivity pneumonitis, rheumatoid arthritis, desquamative interstitial pneumonia (DIP) and end-stage sarcoidosis.
Ground-glass pattern on HRCT is defined as hazy increase in opacity with preservation of bronchial and vascular markings. Whatever the cause may be—i.e. the partial filling of airspaces, the interstitial thickening, the partial collapse of alveoli or the increased capillary blood volume—they all lead to partial displacement of air .
The most common “mimics” of ground-glass pattern are respiratory bronchiolitis-associated interstitial lung disease (RB-ILD), desquamative interstitial pneumonia (DIP), and Pneumocystis pneumonia.
Desquamative interstitial pneumonia (DIP) typically manifests with diffuse ground-glass opacity as the primary pattern with a subpleural and lower lung predominance. A mild subpleural reticular pattern may be seen in half of the cases. Honeycombing and traction bronchiectasis are minimal—if any. Centrilobular emphysema is also seen in DIP as in RBILD, but mild lower zone reticulation is probably more often expected in DIP rather than RBILD . History of smoking should accompany a diagnosis of DIP as it is almost invariably associated with cigarette smoking.
Crazy paving pattern
“Crazy paving” pattern is characterised on HRCT by the presence of thickened interlobular septae and intralobular lines superimposed on a background of ground-glass opacity, resembling irregularly shaped paving stones .
The most commonly encountered mimics of “crazy paving” pattern are Pneumocystis pneumonia, exogenous lipoid pneumonia, sarcoidosis, diffuse alveolar haemorrhage, viral and opportunistic infections and invasive mucinous adenocarcinoma.
Pneumocystis pneumonia may mimic alveolar proteinosis—although it may rarely present with “crazy paving” pattern as the predominant pattern, especially at the resolving or subacute stage . Histological features contributing to the ground-glass attenuation are the foamy nature of the alveolar exudates and the thickening of the alveolar walls by oedema and cellular infiltrates . Clues that are in favour of Pneumocystis pneumonia may be the coexistence of upper lobe lung cysts, and the knowledge of the stage of the disease during treatment.
Although exogenous lipoid pneumonia (ELP) typically presents with consolidation, that is typically low in attenuation (−100 HU), it may also manifest with geographic areas of ground-glass attenuation surrounded by interlobular septal thickening, representing a “crazy paving” pattern. In terms of HRCT, distinctive features that favour lipoid pneumonia over alveolar proteinosis are the presence of ill-defined centrilobular nodules and the coexistence of consolidation . Transbronchial biopsy, bronchoalveolar lavage and a history of oil ingestion are usually diagnostic for ELP.
Viral and opportunistic infections (adenovirus, herpes simplex, influenza virus, cytomegalovirus, respiratory syncytial virus and toxoplasmosis) in immunocompromised patients may commonly manifest with “crazy paving pattern”, as the predominant pattern. Key finding in these cases is the knowledge of immunosuppression from the clinical history .
Mixed ground-glass–reticular pattern
Occasionally, there may be coexistence of ground-glass pattern and reticular pattern—as defined earlier—in the same areas of the lungs and this combination is invariably equal to the presence of irreversible fibrosis .
The most clinically important mimics of mixed ground-glass–reticular pattern are scleroderma, idiopathic pulmonary fibrosis (IPF) and desquamative interstitial pneumonia (DIP).
A nodular pattern is characterised on HRCT by the presence of numerous rounded opacities that range from 2 mm to 1 cm in diameter, with micronodules defined as smaller than 3 mm in diameter . The differential diagnosis—apart from the clinical setting and the ancillary findings—is largely based on the three different patterns of anatomic distribution: perilymphatic, random, and centrilobular. The perilymphatic distribution is characterised by presence of nodules along the peribronchovascular interstitium, interlobular septa and subpleural areas. Random distribution demonstrates nodules without any particular site predominance. Centrilobular nodules are located several millimetres away from the pleural surfaces, interlobar fissures or interlobular septa. Centrilobular distribution further divides into nodules with and without tree-in-bud distribution. Moreover centrilobular nodules without any “tree-in-bud” pattern may be either of homogeneous density or of ground-glass texture.
Lymphangitic carcinomatosis and lymphoproliferative diseases, such as lymphoma, may present with perilymphatic nodules but this does not usually constitute their predominant HRCT pattern and they are accompanied by other findings such as septal thickening (in the former case) and large parenchymal nodules or masses (in the latter case) that help in the differential diagnosis [3, 41].
The most commonly encountered mimics of nodular pattern with random distribution are miliary metastatic disease, as well as other miliary infections such as miliary candidiasis .
Nodular—centrilobular with tree-in-bud pattern
The tree-in-bud pattern represents centrilobular branching structures that resemble a budding tree. The pattern reflects a spectrum of endobronchiolar and peribronchiolar disorders, including mucoid impaction, inflammation, fibrosis and occasionally endovascular disorders such as neoplastic processes.
The most clinically important mimics of nodular with centrilobular tree-in-bud pattern are endobronchial spread of tuberculosis, atypical mycobacteria infection and metastatic tumour emboli.
Metastastatic tumour emboli in pulmonary arterioles may also present with a “tree-in-bud” pattern, which in this case refers to the vascular rather than the bronchial tree. It is either caused by the filling of the centrilobular arteries with tumour emboli or by the fibrocellular intimal hyperplasia induced by tumour microemboli. Ancillary findings may be the multifocal dilatation and beading of arteries, the thickening of the interlobular septae and small wedge-shaped peripheral opacities, secondary to microinfarcts .
Nodular—ill-defined centrilobular (without tree-in-bud) pattern
This pattern is characterised by the presence of poorly defined centrilobular nodules of ground-glass attenuation that appear from the pleural surface, fissures or interlobular septa by several millimetres [4, 41].
The most commonly encountered mimics of nodular ill-defined centrilobular pattern are respiratory bronchiolitis–associated with interstitial lung disease (RBILD), cryptogenic organising pneumonia, lymphocytic interstitial pneumonia and follicular bronchiolitis.
Lymphocytic interstitial pneumonia (LIP) and follicular bronchiolitis may both present with centrilobular micronodules of ground-glass attenuation as the predominant pattern and mimic subacute hypersensitivity pneumonitis. They are considered to represent two ends of a spectrum, with follicular bronchiolitis localised more to the peribronchiolar region and with LIP being more diffuse in the secondary pulmonary lobule. In case of LIP distinctive findings on HRCT may be the associated thickening of the interlobular septae, thin-walled lung cysts, areas of ground-glass opacity and slightly enlarged mediastinal lymphadenopathy. A significant clue from the clinical history is that both entities are strongly associated with underlying autoimmune disease or immunodeficiency, Sjogren’s syndrome, dysproteinaemia or AIDS [58, 59].
A reticulonodular pattern is characterised by the co-occurrence of reticular and micronodular patterns. The micronodules may either be located at the centre of the reticular elements (centrilobular micronodules) or on the linear opacities representing septal or peribronchovascular micronodules .
Berylliosis is the most important mimic of sarcoidosis on imaging and cannot be distinguished from it even on histological basis. Its main HRCT manifestations are the co-occurrence of perilymphatic nodules, thickening of interlobular septa and peribronchovascular interstitial thickening . Lymphadenopathy is expected to be less pronounced than sarcoidosis and the main key finding to reach the correct diagnosis seem to rest on the knowledge of history of exposure.
Lymphangitic carcinomatosis may occasionally present with a reticulonodular pattern characterised by irregular, nodular thickening of the interlobular septae and of the bronchovascular bundles. Differentiating CT findings from sarcoidosis are the preservation of the architecture of the secondary pulmonary lobule, the more diffuse distribution if it is secondary to extrapulmonary cancer or the confinement to one lobe or lung if it is secondary to lung cancer and the less common incidence of mediastinal lymphadenopathy .
Cystic pattern is composed by well-defined, round and circumscribed air-containing parenchymal spaces with a well-defined wall and interface with normal lung. The wall of the cysts may be uniform or varied in thickness, but usually is thin (<2 mm) and occurs without associated emphysema .
The most clinically important mimics of cystic pattern are pulmonary histiocytosis, lymphocytic interstitial pneumonia (LIP) and centrilobular emphysema.
Combined cystic and ground-glass pattern
This combined HRCT pattern is characterised by the co-occurrence of two already mentioned HRCT patterns, i.e. the cystic pattern and the ground-glass pattern.
The most clinically important mimics of combined cystic and ground-glass pattern are lymphocytic interstitial pneumonia, subacute hypersensitivity pneumonitis and desquamative interstitial pneumonia.
Subacute hypersensitivity pneumonitis (HP) may also manifest with this combined HRCT pattern as the predominant pattern. However, in case of HP the lung cysts are reported to be few in number and thin-walled . The distinctive HRCT finding is characteristic lobular areas of decreased attenuation, even from the inspiratory images and the absence of smoking history, since smokers very rarely develop HP .
Decreased attenuation pattern
The decreased attenuation pattern is defined as areas of low density corresponding to parenchymal destruction and reduced perfusion, and attenuation of the pulmonary vasculature. It is also known as the “black lung” pattern.
Mosaic attenuation pattern
This pattern is characterised by a patchwork of intermingled areas of increased and decreased attenuation that may represent (1) patchy interstitial disease, (2) obliterative small airways disease and (3) occlusive small vascular disease .
Subacute hypersensitivity pneumonitis may also exhibit a mosaic attenuation pattern, combining both an “interstitial” cause, manifesting as areas of increased attenuation (ground-glass opacity), and a “small airways disease” cause, manifesting as areas of decreased attenuation, which may accentuate on expiratory CT . Respiratory bronchiolitis may also occasionally produce this pattern.
Evaluation of interstitial lung diseases on HRCT is based on an HRCT-pattern approach to diagnosis, where there should be effort to assign the predominant HRCT pattern to each case. There are various mimics in each HRCT pattern and one entity may have many faces and therefore may mimic many patterns. There may also be possible overlap of HRCT patterns in one case. Moreover, we should keep in mind that no HRCT pattern provides a specific etiological diagnosis. In order to reach a correct and confident diagnosis, one should approach the predominant HRCT pattern by identifying any specific and distinctive imaging clues and try to narrow the differential diagnosis by integrating the HRCT findings with the clinical and laboratory findings.
Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
- Glaspole IN, du Bois RM, Wells AU (2001) The application of high-resolution CT to diagnosis in diffuse parenchymal lung disease. Monaldi Arch Chest Dis 56:233–239PubMedGoogle Scholar
- Elicker B, Pereira CA, Webb R, Leslie KO (2008) High-resolution computed tomography patterns of diffuse interstitial lung disease with clinical and pathological correlation. J Bras Pneumol 34:715–744View ArticlePubMedGoogle Scholar
- Gotway MB, Reddy GP, Webb WR, Elicker BM, Leung JW (2005) High-resolution CT of the lung: patterns of disease and differential diagnoses. Radiol Clin North Am 43:513–542, viiiView ArticlePubMedGoogle Scholar
- Hansell DM, Bankier AA, MacMahon H, McLoud TC, Müller NL, Remy J (2008) Fleischner society: glossary of terms for thoracic imaging. Radiology 246:697–722View ArticlePubMedGoogle Scholar
- Storto ML, Kee ST, Golden JA, Webb WR (1995) Hydrostatic pulmonary edema: high-resolution CT findings. AJR Am J Roentgenol 165:817–820View ArticlePubMedGoogle Scholar
- Johkoh T, Ikezoe J, Tomiyama N, Nagareda T, Kohno N, Takeuchi N, Yamagami H, Kido S, Takashima S, Arisawa J, Kozuka T (1992) CT findings in lymphangitic carcinomatosis of the lung: correlation with histologic findings and pulmonary function tests. AJR Am J Roentgenol 158:1217–1222View ArticlePubMedGoogle Scholar
- Criado E, Sánchez M, Ramírez J, Arguis P, de Caralt TM, Perea RJ, Xaubet A (2010) Pulmonary sarcoidosis: typical and atypical manifestations at high-resolution CT with pathologic correlation. Radiographics 30:1567–1586View ArticlePubMedGoogle Scholar
- Hawtin KE, Roddie ME, Mauri FA, Copley SJ (2010) Pulmonary sarcoidosis: the ‘great pretender’. Clin Radiol 65:642–650View ArticlePubMedGoogle Scholar
- Gawne-Cain ML, Hansell DM (1996) The pattern and distribution of calcified mediastinal lymph nodes in sarcoidosis and tuberculosis: a CT study. Clin Radiol 51:263–267View ArticlePubMedGoogle Scholar
- Rodrigues R, Marchiori E, Müller NL (2004) Niemann-pick disease: high-resolution CT findings in two siblings. J Comput Assist Tomogr 28:52–54View ArticlePubMedGoogle Scholar
- Arnaud L, Pierre I, Beigelman-Aubry C, Capron F, Brun AL, Rigolet A, Girerd X, Weber N, Piette JC, Grenier PA, Amoura Z, Haroche J (2010) Pulmonary involvement in erdheim-chester disease: a single-center study of thirty-four patients and a review of the literature. Arthritis Rheum 62:3504–3512View ArticlePubMedGoogle Scholar
- Nobre LF, Müller NL, de Souza Júnior AS, Marchiori E, Souza IV (2004) Congenital pulmonary lymphangiectasia: CT and pathologic findings. J Thorac Imaging 19:56–59View ArticlePubMedGoogle Scholar
- Boland JM, Tazelaar HD, Colby TV, Leslie KO, Hartman TE, Yi ES (2012) Diffuse pulmonary lymphatic disease presenting as interstitial lung disease in adulthood: report of 3 cases. Am J Surg Pathol 36:1548–1554View ArticlePubMedGoogle Scholar
- Souza CA, Müller NL, Flint J, Wright JL, Churg A (2005) Idiopathic pulmonary fibrosis: spectrum of high-resolution CT findings. AJR Am J Roentgenol 185:1531–1539View ArticlePubMedGoogle Scholar
- MacDonald SL, Rubens MB, Hansell DM, Copley SJ, Desai SR, du Bois RM, Nicholson AG, Colby TV, Wells AU (2001) Nonspecific interstitial pneumonia and usual interstitial pneumonia: comparative appearances at and diagnostic accuracy of thin-section CT. Radiology 221:600–605View ArticlePubMedGoogle Scholar
- Elliot TL, Lynch DA, Newell JD Jr, Cool C, Tuder R, Markopoulou K, Veve R, Brown KK (2005) High-resolution computed tomography features of nonspecific interstitial pneumonia and usual interstitial pneumonia. J Comput Assist Tomogr 29:339–345View ArticlePubMedGoogle Scholar
- Copley SJ, Wells AU, Sivakumaran P, Rubens MB, Lee YC, Desai SR, MacDonald SL, Thompson RI, Colby TV, Nicholson AG, du Bois RM, Musk AW, Hansell DM (2003) Asbestosis and idiopathic pulmonary fibrosis: comparison of thin-section CT features. Radiology 229:731–736View ArticlePubMedGoogle Scholar
- Silva CI, Müller NL, Lynch DA, Curran-Everett D, Brown KK, Lee KS, Chung MP, Churg A (2008) Chronic hypersensitivity pneumonitis: differentiation from idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia by using thin-section CT. Radiology 246:288–297View ArticlePubMedGoogle Scholar
- Kim EJ, Collard HR, King TE Jr (2009) Rheumatoid arthritis-associated interstitial lung disease: the relevance of histopathologic and radiographic pattern. Chest 136:1397–1405PubMed CentralView ArticlePubMedGoogle Scholar
- Hartman TE, Primack SL, Swensen SJ, Hansell D, McGuinness G, Müller NL (1993) Desquamative interstitial pneumonia: thin-section CT findings in 22 patients. Radiology 187:787–790View ArticlePubMedGoogle Scholar
- Hirschmann JV, Pipavath SN, Godwin JD (2009) Hypersensitivity pneumonitis: a historical, clinical, and radiologic review. Radiographics 29:1921–1938View ArticlePubMedGoogle Scholar
- Wells AU, Nicholson AG, Hansell DM, du Bois RM (2003) Respiratory bronchiolitis-associated interstitial lung disease. Semin Respir Crit Care Med 24:585–594View ArticlePubMedGoogle Scholar
- Hidalgo A, Franquet T, Giménez A, Bordes R, Pineda R, Madrid M (2006) Smoking-related interstitial lung diseases: radiologic-pathologic correlation. Eur Radiol 16:2463–2470View ArticlePubMedGoogle Scholar
- Vogel MN, Vatlach M, Weissgerber P, Goeppert B, Claussen CD, Hetzel J, Horger M (2012) HRCT features of pneumocystis jiroveci pneumonia and their evolution before and after treatment in non-HIV immunocompromised patients. Eur J Radiol 81:1315–1320View ArticlePubMedGoogle Scholar
- Murch CR, Carr DH (1989) Computed tomography appearances of pulmonary alveolar proteinosis. Clin Radiol 40:240–243View ArticlePubMedGoogle Scholar
- McGuinness G, Gruden JF (1999) Viral and pneumocystis carinii infections of the lung in the immunocompromised host. J Thorac Imaging 14:25–36View ArticlePubMedGoogle Scholar
- Rossi SE, Erasmus JJ, Volpacchio M, Franquet T, Castiglioni T, McAdams HP (2003) “Crazy-paving” pattern at thin-section CT of the lungs: radiologic-pathologic overview. Radiographics 23:1509–1519View ArticlePubMedGoogle Scholar
- Choi HK, Park CM, Goo JM, Lee HJ (2010) Pulmonary alveolar proteinosis versus exogenous lipoid pneumonia showing crazy-paving pattern: comparison of their clinical features and high-resolution CT findings. Acta Radiol 51:407–412View ArticlePubMedGoogle Scholar
- Collins J, Stern EJ (1997) Ground-glass opacity at CT: the ABCs. AJR Am J Roentgenol 169:355–367View ArticlePubMedGoogle Scholar
- Chung MP, Yi CA, Lee HY, Han J, Lee KS (2010) Imaging of pulmonary vasculitis. Radiology 255:322–341View ArticlePubMedGoogle Scholar
- Marchiori E, Escuissato DL, Gasparetto TD, Considera DP, Franquet T (2009) “Crazy-paving” patterns on high-resolution CT scans in patients with pulmonary complications after hematopoietic stem cell transplantation. Korean J Radiol 10:21–24PubMed CentralView ArticlePubMedGoogle Scholar
- Patsios D, Roberts HC, Paul NS, Chung T, Herman SJ, Pereira A, Weisbrod G (2007) Pictorial review of the many faces of bronchioloalveolar cell carcinoma. Br J Radiol 80:1015–1023View ArticlePubMedGoogle Scholar
- Remy-Jardin M, Giraud F, Remy J, Copin MC, Gosselin B, Duhamel A (1993) Importance of ground-glass attenuation in chronic diffuse infiltrative lung disease: pathologic-CT correlation. Radiology 189:693–698View ArticlePubMedGoogle Scholar
- Desai SR, Veeraraghavan S, Hansell DM, Nikolakopolou A, Goh NS, Nicholson AG, Colby TV, Denton CP, Black CM, du Bois RM, Wells AU (2004) CT features of lung disease in patients with systemic sclerosis: comparison with idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia. Radiology 232:560–567View ArticlePubMedGoogle Scholar
- Devaraj A, Wells AU, Meister MG, Corte TJ, Wort SJ, Hansell DM (2010) Detection of pulmonary hypertension with multidetector CT and echocardiography alone and in combination. Radiology 254:609–616View ArticlePubMedGoogle Scholar
- Heyneman LE, Ward S, Lynch DA, Remy-Jardin M, Johkoh T, Müller NL (1999) Respiratory bronchiolitis, respiratory bronchiolitis-associated interstitial lung disease, and desquamative interstitial pneumonia: different entities or part of the spectrum of the same disease process? AJR Am J Roentgenol 173:1617–1622View ArticlePubMedGoogle Scholar
- Hartman TE, Primack SL, Kang EY, Swensen SJ, Hansell DM, McGuinness G, Müller NL (1996) Disease progression in usual interstitial pneumonia compared with desquamative interstitial pneumonia. Assessment with serial CT. Chest 110:378–382View ArticlePubMedGoogle Scholar
- Brauner MW, Lenoir S, Grenier P, Cluzel P, Battesti JP, Valeyre D (1992) Pulmonary sarcoidosis: CT assessment of lesion reversibility. Radiology 182:349–354View ArticlePubMedGoogle Scholar
- Akira M (2002) High-resolution CT in the evaluation of occupational and environmental disease. Radiol Clin North Am 40:43–59View ArticlePubMedGoogle Scholar
- Remy-Jardin M, Remy J, Farre I, Marquette CH (1992) Computed tomographic evaluation of silicosis and coal workers’ pneumoconiosis. Radiol Clin North Am 30:1155–1176PubMedGoogle Scholar
- Raoof S, Amchentsev A, Vlahos I, Goud A, Naidich DP (2006) Pictorial essay: multinodular disease: a high-resolution CT scan diagnostic algorithm. Chest 129:805–815View ArticlePubMedGoogle Scholar
- Hong SH, Im JG, Lee JS, Song JW, Lee HJ, Yeon KM (1998) High resolution CT findings of miliary tuberculosis. J Comput Assist Tomogr 22:220–224View ArticlePubMedGoogle Scholar
- Voloudaki AE, Tritou IN, Magkanas EG, Chalkiadakis GE, Siafakas NM, Gourtsoyiannis NC (1999) HRCT in miliary lung disease. Acta Radiol 40:451–456View ArticlePubMedGoogle Scholar
- Akira M, Kitatani F, Lee YS, Kita N, Yamamoto S, Higashihara T, Morimoto S, Ikezoe J, Kozuka T (1988) Diffuse panbronchiolitis: evaluation with high-resolution CT. Radiology 168:433–438View ArticlePubMedGoogle Scholar
- Aquino SL, Gamsu G, Webb WR, Kee ST (1996) Tree-in-Bud pattern: frequency and significance on thin section CT. J Comput Assist Tomogr 20:594–599View ArticlePubMedGoogle Scholar
- Im JG, Itoh H, Shim YS, Lee JH, Ahn J, Han MC, Noma S (1993) Pulmonary tuberculosis: CT findings—early active disease and sequential change with antituberculous therapy. Radiology 186:653–660View ArticlePubMedGoogle Scholar
- Koh WJ, Lee KS, Kwon OJ, Jeong YJ, Kwak SH, Kim TS (2005) Bilateral bronchiectasis and bronchiolitis at thin-section CT: diagnostic implications in nontuberculous mycobacterial pulmonary infection. Radiology 235:282–288View ArticlePubMedGoogle Scholar
- Rossi SE, Franquet T, Volpacchio M, Giménez A, Aguilar G (2005) Tree-in-bud pattern at thin-section CT of the lungs: radiologic-pathologic overview. Radiographics 25:789–801View ArticlePubMedGoogle Scholar
- Franquet T, Müller NL, Lee KS, Oikonomou A, Flint JD (2005) Pulmonary candidiasis after hematopoietic stem cell transplantation: thin-section CT findings. Radiology 236:332–337View ArticlePubMedGoogle Scholar
- Franquet T, Müller NL, Oikonomou A, Flint JD (2004) Aspergillus infection of the airways: computed tomography and pathologic findings. J Comput Assist Tomogr 28:10–16View ArticlePubMedGoogle Scholar
- Franquet T (2011) Imaging of pulmonary viral pneumonia. Radiology 260:18–39View ArticlePubMedGoogle Scholar
- Franquet T, Gimenez A, Prats R, Rodriguez-Arias JM, Rodriguez C (2002) Thrombotic microangiopathy of pulmonary tumors: a vascular cause of tree-in-bud pattern on CT. AJR Am J Roentgenol 179:897–899View ArticlePubMedGoogle Scholar
- Baldwin CI, Todd A, Bourke S, Allen A, Calvert JE (1998) Pigeon fanciers’ lung: effects of smoking on serum and salivary antibody responses to pigeon antigens. Clin Exp Immunol 113:166–172PubMed CentralView ArticlePubMedGoogle Scholar
- Furuiye M, Miyake S, Miyazaki Y, Ohtani Y, Inase N, Umino T, Yoshizawa Y (2007) Effect of cigarette smoking on the development of murine chronic pigeon breeder’s lung. The difference between a short-term and a long-term exposure. J Med Dent Sci 54:87–95PubMedGoogle Scholar
- Desai SR, Ryan SM, Colby TV (2003) Smoking-related interstitial lung diseases: histopathological and imaging perspectives. Clin Radiol 58:259–268View ArticlePubMedGoogle Scholar
- Oikonomou A, Hansell DM (2002) Organizing pneumonia: the many morphological faces. Eur Radiol 12:1486–1496View ArticlePubMedGoogle Scholar
- Cordier JF (2000) Organizing pneumonia. Thorax 55:318–328PubMed CentralView ArticlePubMedGoogle Scholar
- Johkoh T, Müller NL, Pickford HA, Hartman TE, Ichikado K, Akira M, Honda O, Nakamura H (1999) Lymphocytic interstitial pneumonia: thin-section CT findings in 22 patients. Radiology 212:567–572View ArticlePubMedGoogle Scholar
- Howling SJ, Hansell DM, Wells AU, Nicholson AG, Flint JD, Müller NL (1999) Follicular bronchiolitis: thin-section CT and histologic findings. Radiology 212:637–642View ArticlePubMedGoogle Scholar
- Hansell DM, Milne DG, Wilsher ML, Wells AU (1998) Pulmonary sarcoidosis: morphologic associations of airflow obstruction at thin-section CT. Radiology 209:697–704View ArticlePubMedGoogle Scholar
- Newman LS, Buschman DL, Newell JD Jr, Lynch DA (1994) Beryllium disease: assessment with CT. Radiology 190:835–840View ArticlePubMedGoogle Scholar
- Johnson SR, Cordier JF, Lazor R, Cottin V, Costabel U, Harari S, Reynaud-Gaubert M, Boehler A, Brauner M, Popper H, Bonetti F, Kingswood C, Review Panel of the ERS LAM Task Force (2010) European respiratory society guidelines for the diagnosis and management of lymphangioleiomyomatosis. Eur Respir J 35:14–26View ArticlePubMedGoogle Scholar
- Silva CI, Flint JD, Levy RD, Müller NL (2006) Diffuse lung cysts in lymphoid interstitial pneumonia: high-resolution CT and pathologic findings. J Thorac Imaging 21:241–244View ArticlePubMedGoogle Scholar
- Murata K, Itoh H, Todo G, Kanaoka M, Noma S, Itoh T, Furuta M, Asamoto H, Torizuka K (1986) Centrilobular lesions of the lung: demonstration by high-resolution CT and pathologic correlation. Radiology 161:641–645View ArticlePubMedGoogle Scholar
- Marchiori E, Müller NL, Soares Souza A Jr, Escuissato DL, Gasparetto EL, Franquet T (2005) Pulmonary disease in patients with AIDS: high-resolution CT and pathologic findings. AJR Am J Roentgenol 184:757–764View ArticlePubMedGoogle Scholar
- Franquet T, Hansell DM, Senbanjo T, Remy-Jardin M, Müller NL (2003) Lung cysts in subacute hypersensitivity pneumonitis. J Comput Assist Tomogr 27:475–478View ArticlePubMedGoogle Scholar
- Hansell DM (2001) HRCT of obliterative bronchiolitis and other small airways diseases. Semin Roentgenol 36:51–65View ArticlePubMedGoogle Scholar
- Copley SJ, Wells AU, Müller NL, Rubens MB, Hollings NP, Cleverley JR, Milne DG, Hansell DM (2002) Thin-section CT in obstructive pulmonary disease: discriminatory value. Radiology 223:812–819View ArticlePubMedGoogle Scholar
- Worthy SA, Flint JD, Müller NL (1997) Pulmonary complications after bone marrow transplantation: high-resolution CT and pathologic findings. Radiographics 17:1359–1371View ArticlePubMedGoogle Scholar
- Oikonomou A, Dennie CJ, Müller NL, Seely JM, Matzinger FR, Rubens FD (2004) Chronic thromboembolic pulmonary arterial hypertension: correlation of postoperative results of thromboendarterectomy with preoperative helical contrast-enhanced computed tomography. J Thorac Imaging 19:67–73View ArticlePubMedGoogle Scholar