Radiological Findings in BO

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Radiological Findings in BO"

Transcription

1 Radiological Findings in BO BO-Meeting 2016 Schloss Johannisberg Geisenheim - Rheingau Germany Dr. Simon Martin Department of Diagnostic and Interventional Radiology University Hospital Frankfurt

2 Bronchiolitis obliterans - Terminology Definition (histopathologic): Concentric luminal narrowing of the membranous and respiratory bronchioles secondary to submucosal and peribronchiolar inflammation and fibrosis without intralumminal granulation tissue and polyps Synonyms: Bronchiolitis obliterans = Obliterative bronchiolitis Constrictive bronchiolitis: characterized by constrictive fibroproliferative narrowing of smallairway walls Bronchiolitis obliterans syndrom (BOS): clinical manifestation of obliterative bronchiolitis in patients who have undergone lung transplantation or HSCT 2

3 Bronchiolitis obliterans with organizing pneumonia (BOOP) Cryptogenic organizing pneumonia COP Pathogenesis: 1. Flooding of plasma proteins in the alveolar lumen. 2. Formation of fibroinflammatory buds. 3. Fibrotic buds clearly delineated inside the alveolar space. Because granulation tissue are present within the lumen of distal airspaces including the bronchioles, COP had been formerly referred to as bronchiolitis obliterans with organizing pneumonia (BOOP). But, OP (and not bronchiolitis) is clearly the major lesion of COP. Cottin, V. and J. F. Cordier (2012). "Cryptogenic organizing pneumonia." Semin Respir Crit Care Med 33(5):

4 COP (BOOP) multiple patchy alveolar opacities density ranging from ground glass to consolidation with air bronchograms. Segment overlapping Cottin, V. and J. F. Cordier (2012). "Cryptogenic organizing pneumonia." Semin Respir Crit Care Med 33(5):

5 Small airways disease High-resolution computed tomography is the most useful modality for imaging of small airways disease e.g.: BO COP (BOOP) Asthma COPD Bronchiolitis

6 Small airways Membranous bronchioles Respiratory bronchioles Average diameter: mm Circumferential epithelium and lack of cartilage Cuboid epithelium Bronchial glands are absent The lumen is rounded The subepithelial connective tissue and muscle are scanty Multiple alveolar walls attached to the bronchiole serve to keep it open during expiration Average diameter: mm the smallest bronchioles that connect the terminal bronchioles to alveolar ducts deliver air to the alveoli They are interrupted by alveoli Participate in gas exchange

7 Do we see small airways disease in CT? Normal, bronchioles cannot be seen to within 20 mm of the pleural surface. Resolution of HRCT > 1 mm If visible pathological finding

8 When do we see small airways in CT? Bronchial wall thickening With/without mucoid impaction Inflammation Interstitial edema Pulmonary edema Infiltration of tumor cells Deposition of proteins, e.g. Amyloid Enlargement Bronchiolectasia Lung fibrosis Teel, G. S., et al. (1996). "Imaging of small airways disease." Radiographics 16(1):

9 Direct signs Micronodules in centrilobular distribution (respiratory bronchiolitis) Mucoid impaction: Tree in Bud

10 Respiratory bronchiolitis: Causes: Viral infect Bacterial infect Chronic bronchitis Pathological disorders: Reactive submucosal and peribronchiolar inflammation. Mucoid impaction with obliteration of the bronchioles. More common in adults Reversible

11 Bronchiolitis? Bronchitis Bronchiolitis Alveolitis Acute bronchitis Inflammation of the bronchi Acute bronchiolitis Obliterative bronchiolitis Acute alveolitis Chronic Bronchitis Bronchiectasis Constrictive bronchiolitis Emphysema Fibrosis

12 Panbronchilotis Seen mainly in Asia Characterized by foamy macrophages in bronchiolar walls in upper and lower airways Thought to follow infection Responds to makrolids High mortality

13 Direct signs Bronchiolectasia

14 Indirect signs Centrilobular emphysema

15 Direct signs Air trapping

16 Bronchiolitis obliterans Pathology: Injury and inflammation of small-airway epithelial cells and subepithelial structures lead to excessive fibroproliferation. This leads to an increased respiratory resistance, which the air must pass through the narrow bronchioles. If there is no healing in this phase, higher grade stenosis incurr, so that no air can pass and the air is scattered in the distal airways.

17 Do we see small airways in BO? In BO the luminal narrowing is invisible Indirect findings: Air trapping Why do we not see atelectasis? Pores of Kohn enable peripheral gas exchange

18 Bronchiolitis obliterans Imaging finding: Inspiratory scans may be complete normal Air trapping at expiratory HRCT No consolidation (in contrast to COP) Bronchiectasis Barker, A. F., et al. (2014). "Obliterative bronchiolitis." N Engl J Med 370(19):

19 Mosaic Perfusion Reduction in caliber of the macroscopic pulmonary vessels

20 Mosaic perfusion Pulmonary embolism

21 Swyer-James-McLeod-Syndrom Postinfecitous obliterative bronchiolitis primalarily involving the lung Unilateral hyperlucent lung that usually develops during childhood as a sequela of postinfectious bronchiolitis obliterans. Can result from various lower respiratory tract infections, including adenovirus, measles, pertussis, tuberculosis, or mycoplasma. The infection leads to inflammation and fibrosis of the respiratory bronchiolar walls and the interalveolar septa. Narrowing of bronchiolar lumens reduces ventilation and leads to compensatory hypoperfusion of the affected lung. This process also results in hyperexpansion of the peripheral airway, which contributes to the hyperlucency seen on imaging studies. Most cases become symptomatic in childhood or early adulthood. 21

22 Swyer-James-McLeod-Syndrom CT findings: Unilateral hyperlucent lung. Pulmonary vasculature small in the affect lung. Air-trapping in the affected side. Mosaic attenuation at HRCT. Bronchiectasis.

23 Swyer-James-Syndrom

24 Differential Diagnosis Asthma No radiological diagnosis. Mosaic perfusion may be identical. CT is important for imaging of complications. Silva CIS, Colby TV, Müller NL. Asthma and Associated Conditions: High-Resolution CT and Pathologic Findings. American Journal of Roentgenology. 2004;183(3):

25 Differential Diagnosis Langerhans cell histiocytosis (LCH) Micronodules more profuse Micronodules may cavitate Upper lobe predominance

26 LAM Lymphangioleiomyomatosis

27 Differential Diagnosis Panlobular Emphysema Destruction of lung parenchyma Lower lobe predominance No mosaic attenuation

28 Differential Diagnosis Desquamative Interstitial Pneumonia (DIP) Diffuse ground-glass opacities Patchy and subpleural Not bronchocentric

29 DIP ground-glass centrilobular emphysema

30 Differential Diagnosis Hypersensitivity Pneumonitis (subacute or chronic) Similar radiographic findings Chronic disease will have more fibrosis

31 Thank you for your attention

High-Resolution Lung CT:

High-Resolution Lung CT: High-Resolution Lung CT: Key Findings and What They Mean 2 W. Richard Webb MD Key HRCT Findings of Lung Disease interlobular septal thickening honeycombing irregular reticular opacities traction bronchiectasis

More information

HRCT of Common Lung Diseases. W. Richard Webb MD

HRCT of Common Lung Diseases. W. Richard Webb MD HRCT of Common Lung Diseases W. Richard Webb MD Common Lung Diseases: HRCT Infections (pneumonia, airways disease) Sarcoidosis Hypersensitivity pneumonitis UIP and idiopathic pulmonary fibrosis (IPF) Nonspecific

More information

Cystic Lung Diseases. Melissa Price Gillian Lieberman, MD Advanced Radiology Clerkship Beth Israel Deaconess Medical Center November, 2008

Cystic Lung Diseases. Melissa Price Gillian Lieberman, MD Advanced Radiology Clerkship Beth Israel Deaconess Medical Center November, 2008 Cystic Lung Diseases Melissa Price Gillian Lieberman, MD Advanced Radiology Clerkship Beth Israel Deaconess Medical Center November, 2008 How do we define a cyst of the lung? Hansell DM, Bankier AA, MacMahon

More information

Idiopathic Interstitial Lung Disease

Idiopathic Interstitial Lung Disease KATHOLIEKE UNIVERSITEIT LEUVEN Faculty of Medicine Idiopathic Interstitial Lung Disease JA Verschakelen, W De Wever Department of Radiology, University Hospitals Leuven, Belgium Goals... To clarify the

More information

Lung Opacity: Atelectasis, Consolidation, Ground Glass Opacity, and Mosaic Attenuation

Lung Opacity: Atelectasis, Consolidation, Ground Glass Opacity, and Mosaic Attenuation Lung Opacity: Atelectasis, Consolidation, Ground Glass Opacity, and Mosaic Attenuation Gautham P. Reddy, MD, MPH University of Washington Learning Objectives Identify lobar or rounded atelectasis Describe

More information

LUNG FIBROSIS FROM THE PATHOLOGIST S POINT OF VIEW THOMAS V. COLBY MD MAYO CLINIC IN ARIZONA

LUNG FIBROSIS FROM THE PATHOLOGIST S POINT OF VIEW THOMAS V. COLBY MD MAYO CLINIC IN ARIZONA LUNG FIBROSIS FROM THE PATHOLOGIST S POINT OF VIEW THOMAS V. COLBY MD MAYO CLINIC IN ARIZONA KEY POINTS: Not all fibrosis in the lung has the same clinical and prognostic implications. Fibroblastic proliferation

More information

The Respiratory System

The Respiratory System The Respiratory System Dr. Ali Ebneshahidi Functions of The Respiratory System To allow gases from the environment to enter the bronchial tree through inspiration by expanding the thoracic volume. To allow

More information

Smoking-Related Small Airway Disease Mary Beth Beasley, MD Mount Sinai Medical Center New York, New York

Smoking-Related Small Airway Disease Mary Beth Beasley, MD Mount Sinai Medical Center New York, New York Smoking-Related Small Airway Disease Mary Beth Beasley, MD Mount Sinai Medical Center New York, New York Background: Small airways are defined as airways with an internal diameter of less than 2mm. The

More information

Influenza (Flu) Influenza is a viral infection that may affect both the upper and lower respiratory tracts. There are three types of flu virus:

Influenza (Flu) Influenza is a viral infection that may affect both the upper and lower respiratory tracts. There are three types of flu virus: Respiratory Disorders Bio 375 Pathophysiology General Manifestations of Respiratory Disease Sneezing is a reflex response to irritation in the upper respiratory tract and is associated with inflammation

More information

Diffuse Lung Disease: A Survival Guide For The Non-Thoracic Radiologist

Diffuse Lung Disease: A Survival Guide For The Non-Thoracic Radiologist Norwegian Society of Thoracic Imaging Oslo, October 2011 Diffuse Lung Disease: A Survival Guide For The Non-Thoracic Radiologist Sujal R Desai King s s College Hospital, London Background Diffuse lung

More information

Fibrotic Interstitial Lung Disease: A Pathologist s Perspective

Fibrotic Interstitial Lung Disease: A Pathologist s Perspective Objectives Fibrotic Interstitial Lung Disease: A Pathologist s Perspective Emil Racila, MD Pathology Department University of Minnesota 1. Recommend appropriate biopsy for suspected condition diagnosis

More information

Interstitial Lung Disease: Alphabet Soup

Interstitial Lung Disease: Alphabet Soup Thank you for viewing this presentation. We would like to remind you that this material is the property of the author. It is provided to you by the ERS for your personal use only, as submitted by the author.

More information

Clinical Syndrome IPF NSIP. AIP Diffuse GG attenuation/consolidation ARDS RB/ RB-ILD. DIP Diffuse GG attenuation Smoking OP (BOOP)

Clinical Syndrome IPF NSIP. AIP Diffuse GG attenuation/consolidation ARDS RB/ RB-ILD. DIP Diffuse GG attenuation Smoking OP (BOOP) pneumonia (): can we tell the difference on Idiopathic Pneumonia: ATS/ERS Classification Idiopathic Pulmonary Fibrosis () vs Non-Specific Interstitial Pneumonitis (): Can We Tell the Difference Clinical

More information

Atlas of Chest Imaging

Atlas of Chest Imaging CHAPTER e34 Atlas of Chest Imaging Patricia Kritek John J. Reilly, Jr. This atlas of chest imaging is a collection of interesting chest radiographs and computed tomograms of the chest. The readings of

More information

Although diseases frequently involve the small airways,

Although diseases frequently involve the small airways, Pathology of Small Airways Disease Timothy Craig Allen, MD, JD N Context. The term small airways disease encompasses a generally poorly understood group of lung diseases that may arise primarily within

More information

Idiopathic Pulmonary Fibrosis: Spectrum of High-Resolution CT Findings

Idiopathic Pulmonary Fibrosis: Spectrum of High-Resolution CT Findings Idiopathic Pulmonary Fibrosis on CT Chest Imaging Pictorial Essay Idiopathic Pulmonary Fibrosis: Spectrum of High-Resolution CT Findings Carolina lthoff Souza 1 Nestor L. Müller 1 Julia Flint 2 Joanne

More information

RESPIRATORY VENTILATION Page 1

RESPIRATORY VENTILATION Page 1 Page 1 VENTILATION PARAMETERS A. Lung Volumes 1. Basic volumes: elements a. Tidal Volume (V T, TV): volume of gas exchanged each breath; can change as ventilation pattern changes b. Inspiratory Reserve

More information

1. Organs of the Respiratory System

1. Organs of the Respiratory System S T U D Y G U I D E 14 1. Organs of the Respiratory System a. Label the parts of the upper respiratory tract by placing the numbers of the structures by the correct labels. 11 Conchae 14 Nasopharynx 15

More information

Rheumatoid Arthritis related Lung Diseases: CT Findings 1

Rheumatoid Arthritis related Lung Diseases: CT Findings 1 Nobuyuki Tanaka, MD Jeung Sook Kim, MD John D. Newell, MD Kevin K. Brown, MD Carlyne D. Cool, MD Richard Meehan, MD Takuya Emoto, MD Tsuneo Matsumoto, MD David A. Lynch, MB Index terms: Arthritis, rheumatoid,

More information

Pulmonary interstitium. Interstitial Lung Disease. Interstitial lung disease. Interstitial lung disease. Causes.

Pulmonary interstitium. Interstitial Lung Disease. Interstitial lung disease. Interstitial lung disease. Causes. Pulmonary interstitium Interstitial Lung Disease Alveolar lining cells (types 1 and 2) Thin elastin-rich connective component containing capillary blood vessels Interstitial lung disease Increase in interstitial

More information

Pulmonary Fibrosis. Pulmonary Fibrosis Case Studies. Mr. H. Normal Lung. Questions. Mechanisms of fibrosis

Pulmonary Fibrosis. Pulmonary Fibrosis Case Studies. Mr. H. Normal Lung. Questions. Mechanisms of fibrosis Mr. H. Pulmonary Fibrosis Case Studies Harold R Collard, MD Assistant Professor of Medicine Interstitial Lung Disease Program University of California San Francisco 62 year old man Dry cough Slowly progressive

More information

Lecture one lung pathology 4 th year MBBS. Dr Asgher Khan Demonstrator of pathology Rawalpindi Medical College Rwp.

Lecture one lung pathology 4 th year MBBS. Dr Asgher Khan Demonstrator of pathology Rawalpindi Medical College Rwp. Lecture one lung pathology 4 th year MBBS Dr Asgher Khan Demonstrator of pathology Rawalpindi Medical College Rwp. Expectation at end of lecture Brief review of anatomy and physiology related to lungs

More information

2.06 Understand the functions and disorders of the respiratory system

2.06 Understand the functions and disorders of the respiratory system 2.06 Understand the functions and disorders of the respiratory system 2.06 Understand the functions and disorders of the respiratory system Essential questions What are the functions of the respiratory

More information

Expiratory CT: Correlation with Pulmonary Function Tests and Value for Discriminating Lung Diseases

Expiratory CT: Correlation with Pulmonary Function Tests and Value for Discriminating Lung Diseases Original Article Expiratory CT: Correlation with Pulmonary Function Tests and Value for Discriminating Lung Diseases Ertuğrul Mavili 1, Hakan Büyükoğlan 2, Nurdan Bulut Çomu 1, Mustafa Güleç 1 Erciyes

More information

Ventilation Perfusion Relationships

Ventilation Perfusion Relationships Ventilation Perfusion Relationships VENTILATION PERFUSION RATIO Ideally, each alveolus in the lungs would receive the same amount of ventilation and pulmonary capillary blood flow (perfusion). In reality,

More information

Recurrent or Persistent Pneumonia

Recurrent or Persistent Pneumonia Recurrent or Persistent Pneumonia Lower Respiratory Tract Dr T Avenant Recurrent or Persistent Pneumonia Definitions Recurrent pneumonia more than two episodes of pneumonia in 18 months Persistent pneumonia

More information

Pulmonary Patterns VMA 976

Pulmonary Patterns VMA 976 Pulmonary Patterns VMA 976 PULMONARY PATTERNS Which pulmonary patterns are commonly described in veterinary medicine? PULMONARY PATTERNS Normal Alveolar Interstitial Structured/Nodular Unstructured Bronchial

More information

Non-specific interstitial pneumonia: findings on sequential CT scans of nine patients

Non-specific interstitial pneumonia: findings on sequential CT scans of nine patients 854 Thorax 2000;55:854 859 Non-specific interstitial pneumonia: findings on sequential CT scans of nine patients Masanori Akira, Giichi Inoue, Satoru Yamamoto, Mitsunori Sakatani Department of Radiology,

More information

-Review Article - High-Resolution CT Evaluation of Ground-Glass Opacity. in Diffuse Lung Disease. Introduction

-Review Article - High-Resolution CT Evaluation of Ground-Glass Opacity. in Diffuse Lung Disease. Introduction NAOSITE: Nagasaki University's Ac Title Author(s) High-Resolution CT Evaluation of Gr Disease Yamaguchi, Tetsuji; Ashizawa, Kazut Citation Acta medica Nagasakiensia. 1998, 43 Issue Date 1998-06-30 URL

More information

The Aged Lung per se and Chronic Pulmonary Diseases in and around the Aged Lung

The Aged Lung per se and Chronic Pulmonary Diseases in and around the Aged Lung Special Article* The Aged Lung per se and Chronic Pulmonary Diseases in and around the Aged Lung Takashi Nakamura I. Introduction Professor of the First Department of Internal Medicine, School of Medicine,

More information

X-Rays. Interpretation of Chest Radiographs. X-ray Absorption. Tissue Density

X-Rays. Interpretation of Chest Radiographs. X-ray Absorption. Tissue Density X-Rays Interpretation of Chest Radiographs Reynard McDonald, MD Medical Director NJMS Global Tuberculosis Institute When x-rays are produced and directed toward the patient, they may act in three basic

More information

Pharmacology of the Respiratory Tract: COPD and Steroids

Pharmacology of the Respiratory Tract: COPD and Steroids Pharmacology of the Respiratory Tract: COPD and Steroids Dr. Tillie-Louise Hackett Department of Anesthesiology, Pharmacology and Therapeutics University of British Columbia Associate Head, Centre of Heart

More information

Idiopathic Pulmonary Fibrosis Diagnosis & Treatment

Idiopathic Pulmonary Fibrosis Diagnosis & Treatment Idiopathic Pulmonary Fibrosis Diagnosis & Treatment Kevin R. Flaherty MD, MS Professor of Medicine University of Michigan Health System Division of Pulmonary/Critical Care Medicine Disclosure Information

More information

CHEST IMAGING RADIOLOGY FUNDAMENTALS: UNDERSTANDING THE CHEST X- RAY RADIOGRAPHIC DENSITIES. Hounsfield Units 10/15/2013

CHEST IMAGING RADIOLOGY FUNDAMENTALS: UNDERSTANDING THE CHEST X- RAY RADIOGRAPHIC DENSITIES. Hounsfield Units 10/15/2013 CHEST IMAGING RADIOLOGY FUNDAMENTALS: UNDERSTANDING THE CHEST X- RAY RADIOGRAPHIC DENSITIES What are the different basic radiographic densities? Density Characteristics 1. Metal 2. Bone 3. Soft Tissue

More information

Idiopathic Pulmonary Fibrosis

Idiopathic Pulmonary Fibrosis 6 Idiopathic Pulmonary Fibrosis Idiopathic pulmonary fibrosis (IPF) (or cryptogenic fibrosing alveolitis) is an archetypal example of lung fibrosis. Although it is the most frequent of all, its etiology

More information

Clinical Anatomy and Physiology of the Chest and Lungs

Clinical Anatomy and Physiology of the Chest and Lungs C H A P T E R Clinical Anatomy and Physiology of the Chest and Lungs 1 1 Many health workers have difficulty understanding and interpreting the clinical signs and symptoms of respiratory diseases. With

More information

Usual Interstitial Pneumonia and Acute Exacerbation. Andrew Synn, HMSIII Gillian Lieberman, MD, BIDMC Radiology November 2008

Usual Interstitial Pneumonia and Acute Exacerbation. Andrew Synn, HMSIII Gillian Lieberman, MD, BIDMC Radiology November 2008 Usual Interstitial Pneumonia and Acute Exacerbation Andrew Synn, HMSIII Gillian Lieberman, MD, BIDMC Radiology November 2008 Agenda Brief clinical history of our patient Review of usual interstitial pneumonia/idiopathic

More information

Restrictive lung diseases

Restrictive lung diseases Restrictive lung diseases Characterized by reduced compliance of the lung. Prominent changes in the interstitium (interstitial lung disease). Important signs and symptoms: - Dyspnea. - Hypoxia. - With

More information

Production Of The Radiograph

Production Of The Radiograph Interpretation Of The Chest Radiograph Arthur Jones, EdD, RRT Learning Objectives: Identify normal landmarks and technical defects on a chest radiograph. Identify common abnormal features on a chest radiograph.

More information

Pharmacology of the Respiratory Tract: COPD and Steroids

Pharmacology of the Respiratory Tract: COPD and Steroids Pharmacology of the Respiratory Tract: COPD and Steroids Dr. Tillie-Louise Hackett Department of Anesthesiology, Pharmacology and Therapeutics University of British Columbia Associate Head, Centre of Heart

More information

Chest X-rays: Author Dr R Katz. Chest X-rays: Programme 3

Chest X-rays: Author Dr R Katz. Chest X-rays: Programme 3 Chest X-rays: Programme 3 In the previous tutorial we looked at the different causes and appearances of increased shadowing in the lungs. I will start this tutorial by briefly looking at the causes of

More information

Differential Diagnoses In Chest Disease

Differential Diagnoses In Chest Disease William Herring, M.D. 2003 Differential Diagnoses In Chest Disease An Incomplete List In Slide Show mode, to advance slides, press spacebar or click left mouse button How to Use This File And How Not to

More information

Diagnostic Testing. SS Visser Pulmonology UP

Diagnostic Testing. SS Visser Pulmonology UP Diagnostic Testing SS Visser Pulmonology UP Tests Conventional XRC Computerized Tomography Magnetic resonance Imaging Scintigraphic Imaging Pulmonary Angiography Ultrasound Lung Function Skin prick testing

More information

Basic Chest X-ray Interpretation Programme 2

Basic Chest X-ray Interpretation Programme 2 Basic Chest X-ray Interpretation Programme 2 In this second chest x-ray tutorial I will now start to look at some of the more commonly encountered pathologies. I have split this up into abnormalities involving

More information

Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA & 2006 USCAP, Inc All rights reserved 0893-3952/06 $30.00 www.modernpathology.org Respiratory bronchiolitis-associated interstitial lung disease with fibrosis is a lesion distinct from fibrotic nonspecific

More information

Human Anatomy and Physiology The Respiratory System

Human Anatomy and Physiology The Respiratory System Human Anatomy and Physiology The Respiratory System Basic functions of the respiratory system: as a Gas exchange supply oxygen to aerobic tissues in the body and remove carbon dioxide waste product. in-

More information

Imaging features of pulmonary sarcoidosis - a pictorial essay

Imaging features of pulmonary sarcoidosis - a pictorial essay Imaging features of pulmonary sarcoidosis - a pictorial essay Poster No.: P-0049 Congress: ESTI 2014 Type: Authors: Keywords: DOI: Educational Poster P. Paixao, T. Sequeira, W. Schmitt, P. Cabral, I. Santiago;

More information

September 2008 [KT 168] Sub. Code: 2063 M.D. DEGREE EXAMINATION Branch XVII Tuberculosis and Respiratory Diseases NON-TUBERCULOSIS CHEST DISEASES Common to Part II Paper II - (Old /New/Revised Regulations)

More information

Congestive Heart Failure

Congestive Heart Failure William Herring, M.D. 2002 Congestive Heart Failure In Slide Show mode, to advance slides, press spacebar or click left mouse button Congestive Heart Failure Causes of Coronary artery disease Hypertension

More information

Primary -Benign - Malignant Secondary

Primary -Benign - Malignant Secondary TUMOURS OF THE LUNG Primary -Benign - Malignant Secondary The incidence of lung cancer has been increasing almost logarithmically and is now reaching epidemic levels. The overall cure rate is very low

More information

Online supplements are not copyedited prior to posting.

Online supplements are not copyedited prior to posting. Functional Impact of a Spectrum of Interstitial Lung Abnormalities in Rheumatoid Arthritis Tracy J. Doyle, MD, MPH; Paul F. Dellaripa, MD; Kerri Batra, MD; Michelle L. Frits, BA; Christine K. Iannaccone,

More information

General Thoracic Surgery ICD9 to ICD10 Crosswalks. C34.11 Malignant neoplasm of upper lobe, right bronchus or lung

General Thoracic Surgery ICD9 to ICD10 Crosswalks. C34.11 Malignant neoplasm of upper lobe, right bronchus or lung ICD-9 Code ICD-9 Description ICD-10 Code ICD-10 Description 150.3 Malignant neoplasm of upper third of esophagus C15.3 Malignant neoplasm of upper third of esophagus 150.4 Malignant neoplasm of middle

More information

Combined pulmonary fibrosis and empyhsema (CPFE) syndrome: imaging findings and follow-up.

Combined pulmonary fibrosis and empyhsema (CPFE) syndrome: imaging findings and follow-up. Combined pulmonary fibrosis and empyhsema (CPFE) syndrome: imaging findings and follow-up. Poster No.: C-0297 Congress: ECR 2014 Type: Scientific Exhibit Authors: F. Ciccarese, D. Attinà, M. Zompatori;

More information

Pneumonia. Acute inflammation of lung parenchyma Inflammatory infiltrate in alveoli ( = consolidation)

Pneumonia. Acute inflammation of lung parenchyma Inflammatory infiltrate in alveoli ( = consolidation) Pneumonia Acute inflammation of lung parenchyma Inflammatory infiltrate in alveoli ( = consolidation) CLASSIFICATION: Aetiology. Morpological class. - Bronchopneumonia vs. lobar pneumonia. Community acquired

More information

The Radiology of Tuberculosis

The Radiology of Tuberculosis The Radiology of Tuberculosis David Ashkin, M.D., F.C.C.P. Medical Director, Southeastern National Tuberculosis Center Medical Director, Florida Bureau of TB and Refugee Health Clinical Assistant Professor,

More information

Interstitial lung disease in a rheumatic electrician

Interstitial lung disease in a rheumatic electrician Interstitial lung disease in a rheumatic electrician Case history The case presented here concerns a male, born in 1931, who was an electrician for 34 years. He had frequent and close contact with asbestos,

More information

PULMONARY TUBERCULOSIS

PULMONARY TUBERCULOSIS PULMONARY TUBERCULOSIS GENERAL CONSIDERATIONS Communicable Granulomatous disease caused by Mycobacterium Tuberculosis. [M. avium- -30% of patients with AIDS] Tuberculosis is a chronic infection, potentially

More information

The Idiopathic Interstitial Pneumonia

The Idiopathic Interstitial Pneumonia The Idiopathic Interstitial Pneumonias Andrew Churg, MD Departments of Pathology University of British Columbia and Vancouver General Hospital Vancouver, BC, Canada achurg@mail.ubc.ca General Comments

More information

Role of HRCT in Diagnosis of Asbestos Related Pleuro Pulmonary Disease

Role of HRCT in Diagnosis of Asbestos Related Pleuro Pulmonary Disease Cairo University Role of HRCT in Diagnosis of Asbestos Related Pleuro Pulmonary Disease ESSAY Submitted for partial fulfillment of Master degree in Radio-diagnosis By Rania Adel Abd ElRahem Elghetany (M.B.B.CH.,

More information

A. All cells need oxygen and release carbon dioxide why?

A. All cells need oxygen and release carbon dioxide why? I. Introduction: Describe how the cardiovascular and respiratory systems interact to supply O 2 and eliminate CO 2. A. All cells need oxygen and release carbon dioxide why? B. Two systems that help to

More information

Idiopathic Bronchiolocentric Interstitial Pneumonia

Idiopathic Bronchiolocentric Interstitial Pneumonia Idiopathic Bronchiolocentric Interstitial Pneumonia Samuel A. Yousem, MD, Sanja Dacic, MD, PhD Department of Pathology, University of Pittsburgh Medical Center, Presbyterian University Hospital, Pittsburgh,

More information

بسم اهلل الرحمن الرحيم

بسم اهلل الرحمن الرحيم بسم اهلل الرحمن الرحيم College of medicine 432 ASTHMA Done By Mohammed Abdullah Alghammass *please make sure you read the objectives from the reading material file Asthma: Asthma is a chronic inflammatory

More information

Respiratory Concerns in Children with Down Syndrome

Respiratory Concerns in Children with Down Syndrome Respiratory Concerns in Children with Down Syndrome Paul E. Moore, M.D. Associate Professor of Pediatrics and Pharmacology Director, Pediatric Allergy, Immunology, and Pulmonary Medicine Vanderbilt University

More information

Thoracic Manifestations of

Thoracic Manifestations of Cardiopulmonary Imaging Pictorial Essay etancourt et al. Inflammatory owel Disease Cardiopulmonary Imaging Pictorial Essay Downloaded from www.ajronline.org by 37.44.207.91 on 12/21/16 from IP address

More information

Interstitial lung disease

Interstitial lung disease Interstitial lung disease William D Travis Abstract Idiopathic interstitial pneumonias represent an important group of interstitial lung diseases, encompassing seven entities: (1) usual interstitial pneumonia

More information

PART 2 D.HAMMOUDI.MD

PART 2 D.HAMMOUDI.MD LUNG ANATOMY PART 2 D.HAMMOUDI.MD Developmental Aspects Olfactory placodes invaginatei into olfactory pits by the 4 th week Laryngotracheal buds are present by the 5 th week Mucosae of the bronchi and

More information

Churg Strauss syndrome is a rare vasculitis of unknown

Churg Strauss syndrome is a rare vasculitis of unknown ORIGINAL ARTICLE High Resolution CT and Pathologic Findings Cleonice Isabela S. Silva, MD,* Nestor L. Müller, MD, PhD, Kiminori Fujimoto, MD, PhD, Takeshi Johkoh, MD, PhD, Sérgio A. Ajzen, MD,* and Andrew

More information

Pediatric Respiratory System: Basic Anatomy & Physiology. Jihad Zahraa Pediatric Intensivist Head of PICU, King Fahad Medical City

Pediatric Respiratory System: Basic Anatomy & Physiology. Jihad Zahraa Pediatric Intensivist Head of PICU, King Fahad Medical City Pediatric Respiratory System: Basic Anatomy & Physiology Jihad Zahraa Pediatric Intensivist Head of PICU, King Fahad Medical City Outline Introduction Developmental Anatomy Developmental Mechanics of Breathing

More information

Defending the Rest Basics on Lung Cancer, Other Cancers and Asbestosis: Review of the B-Read and Pulmonary Function Testing

Defending the Rest Basics on Lung Cancer, Other Cancers and Asbestosis: Review of the B-Read and Pulmonary Function Testing Defending the Rest Basics on Lung Cancer, Other Cancers and Asbestosis: Review of the B-Read and Pulmonary Function Testing ASBESTOSIS November 2013 Bruce T. Bishop Lucy L. Brandon Willcox & Savage 440

More information

Swine-Origin Influenza A (H1N1) Viral Infection: Thoracic Findings on CT

Swine-Origin Influenza A (H1N1) Viral Infection: Thoracic Findings on CT Cardiopulmonary Imaging Pictorial Essay Marchiori et al. CT of H1NI Viral Infection Cardiopulmonary Imaging Pictorial Essay Swine-Origin Influenza (H1N1) Viral Infection: Thoracic Findings on CT Edson

More information

Idiopathic Interstitial Pneumonias: CT Features 1

Idiopathic Interstitial Pneumonias: CT Features 1 Review Radiology David A. Lynch, MD William D. Travis, MD Nestor L. Müller, MD, PhD Jeffrey R. Galvin, MD David M. Hansell, MD Philippe A. Grenier, MD Talmadge E. King, Jr, MD Published online 10.1148/radiol.2361031674

More information

Tests. Pulmonary Functions

Tests. Pulmonary Functions Pulmonary Functions Tests Static lung functions volumes Dynamic lung functions volume and velocity Dynamic Tests Velocity dependent on Airway resistance Resistance of lung tissue to change in shape Dynamic

More information

Nonspecific Interstitial Pneumonia

Nonspecific Interstitial Pneumonia 8 Nonspecific Interstitial Pneumonia The recognition that lung biopsy samples from some patients with idiopathic interstitial disease do not fit into any well-defined histological patterns of idiopathic

More information

Respiratory System. Biol 105 Lecture 18 Chapter 14

Respiratory System. Biol 105 Lecture 18 Chapter 14 Respiratory System Biol 105 Lecture 18 Chapter 14 Outline - Respiratory System I. Function of the respiratory system II. Parts of the respiratory system III. Mechanics of breathing IV. Regulation of breathing

More information

Chest Radiography Interpretation: Reading Chest Films

Chest Radiography Interpretation: Reading Chest Films Chest Radiography Interpretation: Reading Chest Films Lisa Chen, M.D. Assistant Clinical Professor Pulmonary and Critical Care Division Department of Medicine San Francisco General Hospital Michael Gotway,

More information

Occupational Lung Disease. David Perlman, MD

Occupational Lung Disease. David Perlman, MD Occupational Lung Disease David Perlman, MD What causes occupational lung diseases? Breathing bad stuff into your lung Mechanism of particle deposition Large particles (>0.5μM) Impaction Gravitational

More information

PULMONARY IMAGING: GETTING THE MOST INFORMATION FROM THORACIC RADIOGRAPHS

PULMONARY IMAGING: GETTING THE MOST INFORMATION FROM THORACIC RADIOGRAPHS PULMONARY IMAGING: GETTING THE MOST INFORMATION FROM THORACIC RADIOGRAPHS Peter Scrivani, DVM, DACVR Cornell University College of Veterinary Medicine, Ithaca, NY Outline Pulmonary Imaging Pulmonary anatomy

More information

Diseases. Inflammations Non-inflammatory pleural effusions Pneumothorax Tumours

Diseases. Inflammations Non-inflammatory pleural effusions Pneumothorax Tumours Pleura Visceral pleura covers lungs and extends into fissures Parietal pleura limits mediastinum and covers dome of diaphragm and inner aspect of chest wall. Two layers between them (pleural cavity) contains

More information

Thibodeau: Anatomy and Physiology, 5/e. Chapter 23: Anatomy of the Respiratory System

Thibodeau: Anatomy and Physiology, 5/e. Chapter 23: Anatomy of the Respiratory System Thibodeau: Anatomy and Physiology, 5/e Chapter 23: Anatomy of the Respiratory System Naturally, the structure, location, and function of the organs of the respiratory system are the focus of this entire

More information

Objectives COPD. Chronic Obstructive Pulmonary Disease (COPD) 4/19/2011

Objectives COPD. Chronic Obstructive Pulmonary Disease (COPD) 4/19/2011 Objectives Discuss assessment findings and treatment for: Chronic Obstructive Pulmonary Disease Bronchitis Emphysema Asthma Anaphylaxis Other respiratory issues Provide some definitions Chronic Obstructive

More information

Respiratory System. Chapter 21

Respiratory System. Chapter 21 Respiratory System Chapter 21 Structural Anatomy Upper respiratory system Lower respiratory system throat windpipe voice box Function of Respiratory System Gas exchange Contains receptors for sense of

More information

Parenchymal Lung Diseases. SS Visser Lung Unit UP and PAH

Parenchymal Lung Diseases. SS Visser Lung Unit UP and PAH Parenchymal Lung Diseases SS Visser Lung Unit UP and PAH Contents Structure of the lung parenchyma Etiology of parenchymal diseases Pathogenesis Physical signs Diagnosis Complications Management Structure

More information

The introduction of high-resolution computed tomography

The introduction of high-resolution computed tomography SYMPOSIA Chronic Obstructive Pulmonary Disease: Radiology-Pathology Correlation Sudhakar N. J. Pipavath, MD,* Rodney A. Schmidt, MD,w Julie E. Takasugi,z and J. David Godwin, MDy Abstract: Chronic obstructive

More information

Documenting & Coding. Chronic Obstructive Pulmonary Disease (COPD) Presented by: David S. Brigner, MLA, CPC

Documenting & Coding. Chronic Obstructive Pulmonary Disease (COPD) Presented by: David S. Brigner, MLA, CPC Documenting & Coding Chronic Obstructive Pulmonary Disease (COPD) Presented by: David S. Brigner, MLA, CPC Sr. Provider Training & Development Consultant Professional Profile David Brigner currently performs

More information

Pneumocystis Jiroveci: Imaging Findings on HRCT

Pneumocystis Jiroveci: Imaging Findings on HRCT Pneumocystis Jiroveci: Imaging Findings on HRCT Poster No.: C-2491 Congress: ECR 2015 Type: Educational Exhibit Authors: R. E. Correa Soto, J. M. Fernandez Garcia-Hierro, M. J. Martín 1 1 2 1 1 Sánchez,

More information

LungMAP_Mouse_Anatomy_v

LungMAP_Mouse_Anatomy_v LungMAP_Mouse_Anatomy_v2.7 2016-04-30 The LMMA ID is a 10-digit number (e.g. LMHA0000000089). Here we use an abbreviated form, LMHA.. 3 digits (e.g.; LMMA.. 089), for easy viewing. LMMA.. 210 lower respiratory

More information

MECHINICAL VENTILATION S. Kache, MD

MECHINICAL VENTILATION S. Kache, MD MECHINICAL VENTILATION S. Kache, MD Spontaneous respiration vs. Mechanical ventilation Natural spontaneous ventilation occurs when the respiratory muscles, diaphragm and intercostal muscles pull on the

More information

Chest X-Ray Interpretation for the Internist. Theresa Cuoco, MD August 2, 2012

Chest X-Ray Interpretation for the Internist. Theresa Cuoco, MD August 2, 2012 Chest X-Ray Interpretation for the Internist Theresa Cuoco, MD August 2, 2012 Disclaimer: I am NOT a radiologist! Why do we need to know? To direct care while awaiting an official read Low level radiation

More information

Common and uncommon manifestations of Organizing Pneumonia: Radiologic-Clinical-Pathologic Correlation

Common and uncommon manifestations of Organizing Pneumonia: Radiologic-Clinical-Pathologic Correlation Common and uncommon manifestations of Organizing Pneumonia: Radiologic-Clinical-Pathologic Correlation Poster No.: C-2206 Congress: ECR 2014 Type: Educational Exhibit Authors: G. Solana Tubau, A. Robles

More information

X-Rays. Interpretation of Chest Radiographs. X-ray Absorption. Tissue Density

X-Rays. Interpretation of Chest Radiographs. X-ray Absorption. Tissue Density X-Rays Interpretation of Chest Radiographs Reynard McDonald, MD Medical Director NJMS Global Tuberculosis Institute When x-rays are produced and directed toward the patient, they may act in three basic

More information

Basic Chest X-Ray Interpretation. R. Baak, acute zorg presentatie

Basic Chest X-Ray Interpretation. R. Baak, acute zorg presentatie Basic Chest X-Ray Interpretation R. Baak, acute zorg presentatie X-rays- describe radiation which is part of the spectrum which includes visible light, gamma rays and cosmic radiation. Unlike visible light,

More information

GOVERNMENT OF INDIA AERONAUTICAL INFORMATION SERVICES DIRECTOR GENERAL OF CIVIL AVIATION OPPOSITE SAFDARJUNG AIRPORT NEW DELHI

GOVERNMENT OF INDIA AERONAUTICAL INFORMATION SERVICES DIRECTOR GENERAL OF CIVIL AVIATION OPPOSITE SAFDARJUNG AIRPORT NEW DELHI Telephone No. 2:4622495 Telegraphic Address: Commercial : AIRCIVIL NEW DELHI Aeronautical : VIDDYAYX E Mail: dri@dgca.nic.in Fax : 01124629221 GOVERNMENT OF INDIA AERONAUTICAL INFORMATION SERVICES DIRECTOR

More information

Occupational Lung Disease. SS Visser Internal Medicine UP

Occupational Lung Disease. SS Visser Internal Medicine UP Occupational Lung Disease SS Visser Internal Medicine UP Classification Anorganic ( mineral ) dust/pneumoconiosis Fibrogenic - silica, asbestos, talc, silicates Non-fibrogenic - Fe, barium, tin Immunologic/Pharmcologic

More information

Department of Surgery

Department of Surgery What is emphysema? 2004 Regents of the University of Michigan Emphysema is a chronic disease of the lungs characterized by thinning and overexpansion of the lung-like blisters (bullae) in the lung tissue.

More information

A. function: supplies body with oxygen and removes carbon dioxide. a. O2 diffuses from air into pulmonary capillary blood

A. function: supplies body with oxygen and removes carbon dioxide. a. O2 diffuses from air into pulmonary capillary blood A. function: supplies body with oxygen and removes carbon dioxide 1. ventilation = movement of air into and out of lungs 2. diffusion: B. organization a. O2 diffuses from air into pulmonary capillary blood

More information

Definition of radiographic patterns of the silicosis in Mongolia according to the ILO International classification

Definition of radiographic patterns of the silicosis in Mongolia according to the ILO International classification Definition of radiographic patterns of the silicosis in Mongolia according to the ILO International classification L.Munkhtsetseg 1, D.Khishigtogtokh 1 1 Occupational physician of the National Center for

More information

ANATOMY AND PHYSIOLOGY OF THE PULMONARY SYSTEM Section 1 Part B Reading Assignment: Des Jardins - Chapter 1, pp. THE LOWER AIRWAY I.

ANATOMY AND PHYSIOLOGY OF THE PULMONARY SYSTEM Section 1 Part B Reading Assignment: Des Jardins - Chapter 1, pp. THE LOWER AIRWAY I. ANATOMY AND PHYSIOLOGY OF THE PULMONARY SYSTEM Section 1 Part B Reading Assignment: Des Jardins - Chapter 1, pp. THE LOWER AIRWAY I. Cartilaginous Airways A. Trachea 1. extends from the cricoid cartilage

More information

TB and COPD 衛生福利部胸腔病院 張祐泟醫師

TB and COPD 衛生福利部胸腔病院 張祐泟醫師 TB and COPD 衛生福利部胸腔病院 張祐泟醫師 COPD is estimated to affect 65 million people worldwide COPD predicted to be third leading cause of death in 2030 3 million deaths annually 90 % of these deaths are in low-

More information