LYMPHANGITIC CARCINOMATOSIS“CERTAIN CANCERS SPREAD BY PLUGGING THE LYMPHATICS”

CervixColonStomachBreastPancreas ThyroidLarynx

From: Radiology: The Oral Boards PrimerBy: A. Mehta and D. P. Beall © Humana Press Inc., Totowa, NJ

2Chest Radiology

Includes plain film diagnosis, CT, MRI, and interventional techniques used in thediagnosis of diseases of the lungs, pleura, and mediastinum including the heartand great vessels.

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34 Radiology: The Oral Boards Primer

MULTIPLE NODULES OR MASS >3 CM

BRONCHIOLITIS OBLITERANSCRITTERS

COP/BOOPRheumatoidInfectious-Swyer JamesTransplantToxinsSarcoid

DAYS OF THE WEEK: MTWTFSS

Mets/Carcinoma/LymphomaTB/granulomaWegenersRheumatoid nodules/Round pneumoniaFungalSarcoidSeptic pulmonary emboli

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Chapter 2 / Chest Radiology 35

COIN LESION <3 CMCHANGE

Carcinoma/CongenitalHamartoma/HematomaAVM/AbscessNeoplasm–metsGranuomaEsoteric-TB pneumonia

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36 Radiology: The Oral Boards Primer

A CT scan should be done to assess:Ca2+ pattern

Benign: solid, lamellated, centralMalignant: stippled, any other pattern.Density: fat - Hamartoma

Margins:Spiculated suggestive of carcinoma

EnhancementFour 1-min images >15HU suggestive

Growth

CAVITYCAVITY

Carcinoma-SCCAbscess-fungal/bacterial/TBVascular-septic emboliInflammatory-rheumatoid noduleTrauma-resolving contusionYoung-bronchogenic cyst

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Chapter 2 / Chest Radiology 37

CAVITY (continued)

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38 Radiology: The Oral Boards Primer

BRONCHOVASCULAR SPREADSKILL

SarcoidKaposiInfection–PCP/TBLymphomaLymphagitic spread

UNILATERAL HYPERLUCENT LUNG

POEMS

Poland syndrome/PneumothoraxOligemia/Obstruction (PE)EmphysemaMastectomySwyer James

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Chapter 2 / Chest Radiology 39

ACUTE INTERSTITIAL DISEASE (RETICULAR)HELP

Hypersensitivity pneumonitisEdema-Inhalation injuriesLymphoproliferativePneumonia-atypicals, PCP

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CHRONIC INTERSTITIAL DISEASE (RETICULAR)PAGE CHUCK AT THE CIA RIGHT NOW, THERE’S DRUGS

UPPER LUNG ZONES

PneumoconiosisAnkylosing spondylitisGranulomatousEosinophillicSarcoid/Silicosis

MID LUNG ZONES

Chronic Hypersensitivity

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Chapter 2 / Chest Radiology 41

LOWER LUNG ZONES

Collagen vascular diseaseIPFAsbestosRheumatoidNFDrug toxicity

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ACUTE AIRSPACE DISEASEHELP LEGALIZE HEMP

DIFFUSE

HemorrhageEdemaLymphoproliferative—esotericPneumonia

FOCAL

Hemorrhage-contusion/PEEdema-inhalation (crack)MI (RUL)Pneumonia

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Chapter 2 / Chest Radiology 43

CHRONIC AIRSPACE DISEASEPEBBLES

PAP/PCP/PedemaEosinophillic pneumoniaBACBOOPLymphomaEsoteric-Wegener’s/TBSarcoid/Septic pulmonary emboli

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44 Radiology: The Oral Boards Primer

GROUND GLASS DIFFUSE OPACITYSHAKE YOUR HIPS IN BED

SarcoidHypersensitivity—smokersInfectionPneumonitis—DIPScleroderma/CVDBOOPEdema/aspirationDrug toxicitiy

CENTRAL OPACITIES EXTENDINGFROM THE HILA OUTWARDS

PPPP

PAPPulmonary edemaPCPPneumonia–atypical/influenza

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Chapter 2 / Chest Radiology 45

MIDDLE MEDIASTINAL MASSHABIT

Hernia, HematomaAneurysmBronchogenic cyst/duplication cystInflammation (sarcoidosis, histoplasmosis, coccid-

ioidomycosis, primary TB in children)Tumors–remember the five Ls:

Lung, especially oat cell LymphomaLeukemiaLeiomyomaLymph node hyperplasia

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RETICULAR (CXR)/CYSTIC OPACITIES (CT)ELECT CHIP

EGLAMEmphysemaCFTSCoccidiomycosisHydrocarbonInfectiousPCP

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Chapter 2 / Chest Radiology 47

FINGER IN GLOVE OPACITIESCACACA

CFAsthmaCongential bronchial atresiaABPACancerAVM

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CRAZY PAVING (CT)ACUTE

EdemaHemorrhage

CHRONIC

PAPSarcoidPCPFibrosis

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Chapter 2 / Chest Radiology 49

END-STAGE LUNG (CXR)—ARCHITECTURAL DESTRUCTION

TESSA

TBEGSarcoidSilicosisARDS—The sequela of

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CA2+ NODULESMASH POX

Metastatic diseaseAlveolar microlithiasisSilicosis/siderosisHistoplasmosisPox (Varicella)

TREE IN BUD OPACITIES (CT)MIT

Mucous plugging: Aspiration/KartagenersInflammatory plugging (PUS): TB/MAITumor emboli (rare)

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Chapter 2 / Chest Radiology 51

NODULES (CT)DIFFUSE

MISSLE

MetsInfectionSarcoidSilicosisLymphomaEG

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PERILYMPHATIC

A SKILL

AmyloidSarcoidKaposi’sInfection (PCP)LymphomaLymphang carcinomatosis

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Chapter 2 / Chest Radiology 53

CENTRILOBULAR

HERB HAS GAS

Hypersen pneumonitisEGRB-ILDBAC/BOOPGVHDVASculitis

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BRONCHIECTASISCAPT KANGAROO HAS MOUNIER KUHN

Cystic fibrosisABPAPostinfectiousTBKartagener’sMounier Kuhn

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Chapter 2 / Chest Radiology 55

TRACHEAL NEOPLASMSMultiple

TRAM

TracheobronchopathiaRelapsing polychondritisMetsastasis

Single

MATCH

MucoepidermoidAdenoid cysticTracheal SCCCarcinoidHamartoma

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56 Radiology: The Oral Boards Primer

Cardiac

CARDIOMYOPATHYRESTRICTIVE

SarcoidHemochromatosisAmyloidEndocardial fibroelastosis

HYPERTROPHIC

ObstructiveNonobstructive

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Chapter 2 / Chest Radiology 57

Dilated

PERICARDIUM

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58 Radiology: The Oral Boards Primer

CA2+

UremicViralTBPrior hemorrhage

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