Radiological Differential Radiological Differential Diagnosis of Chest Diagnosis of Chest
DiseasesDiseasesAn Incomplete ListAn Incomplete List
Devesh ChauhanDevesh Chauhan
Anterior Mediastinal Anterior Mediastinal MassesMasses
•ThymomaThymoma•TeratomaTeratoma•Sub-sternal thyroidSub-sternal thyroid•LymhomaLymhoma
Opacified HemithoraxOpacified Hemithorax
• AtelectasisAtelectasis
• PneumoniaPneumonia
• Pleural effusionPleural effusion
• Post-pneumonectomyPost-pneumonectomy
PneumomediastinumPneumomediastinum
• Ruptured esophagus.Ruptured esophagus.
• Ruptured trachea/bronchus.Ruptured trachea/bronchus.
• Iatrogenic.Iatrogenic.
• Asthma.Asthma.
• Pneumoperitoneum.Pneumoperitoneum.
Acute Alveolar Acute Alveolar InfiltrateInfiltrate
• Pulmonary edemaPulmonary edema• Pneumonia Pneumonia • AspirationAspiration• HemorrhageHemorrhage
Chronic Alveolar DiseaseChronic Alveolar Disease
–Alveolar cell carcinoma.Alveolar cell carcinoma.
–Alveolar sarcoid.Alveolar sarcoid.
–Lymphoma.Lymphoma.
–Alveolar Proteinosis.Alveolar Proteinosis.
Large Cavitary Lung LesionLarge Cavitary Lung Lesion
• AbscessAbscess
• Carcinoma.Carcinoma.
• Tuberculosis.Tuberculosis.
Bibasilar Interstitial DiseaseBibasilar Interstitial Disease
• Bronchiectasis.Bronchiectasis.
• AspirationAspiration
• Desquamative Interstitial Pneumonitis Desquamative Interstitial Pneumonitis (DIP).(DIP).
• Asbestosis.Asbestosis.
• Sickle Cell Disease.Sickle Cell Disease.
• Scleroderma.Scleroderma.
Upper Lobe DiseaseUpper Lobe Disease
• Post primary Tuberculosis.Post primary Tuberculosis.
• Silicosis.Silicosis.
• Eosinophilic Granuloma.Eosinophilic Granuloma.
• Ankylosing Spondylitis.Ankylosing Spondylitis.
Micro-nodular Lung DiseaseMicro-nodular Lung Disease
• Metastasis.Metastasis.
• Sarcoid.Sarcoid.
• Pneumoconiosis.Pneumoconiosis.
• Miliary Tuberculosis.Miliary Tuberculosis.
Chronic Interstitial DiseaseChronic Interstitial DiseasePulmonary Fibrosis
• Pneumoconiosis.Pneumoconiosis.
• Interstitial Pneumonia.Interstitial Pneumonia.
• Granulomatous Disease.Granulomatous Disease.
• Neoplastic disease.Neoplastic disease.
• Idiopathic fibrosis.Idiopathic fibrosis.
• Collagen vascular diseaseCollagen vascular disease
Small Cavitary Lung LesionsSmall Cavitary Lung Lesions
• Septic emboli.Septic emboli.
• Rheumatoid nodules.Rheumatoid nodules.
• Squamous or transitional cell Squamous or transitional cell metastasis.metastasis.
• Wegener’s Granulomatosis.Wegener’s Granulomatosis.
Lymphangitic Spread to the LungsLymphangitic Spread to the Lungs
• Lung Carcinoma.Lung Carcinoma.
• Breast Carcinoma.Breast Carcinoma.
• Stomach Carcinoma.Stomach Carcinoma.
• Pancreas carcinoma.Pancreas carcinoma.
• Laryngeal Carcinoma.Laryngeal Carcinoma.
• Cervical Carcinoma.Cervical Carcinoma.
Multiple Lung NodulesMultiple Lung Nodules
• Metastasis.Metastasis.
• Wegener’s granulomatosis.Wegener’s granulomatosis.
• Rheumatoid nodules.Rheumatoid nodules.
• Arterio-venous malformations.Arterio-venous malformations.
• Septic emboliSeptic emboli.
Pulmonary Interstitial EdemaPulmonary Interstitial Edema
• Congestive heart failure.Congestive heart failure.
• Lymphangitic spread.Lymphangitic spread.
• Allergic reaction.Allergic reaction.
Shifting InfiltratesShifting Infiltrates
• Loeffler’s Syndrome.Loeffler’s Syndrome.
• Allergic broncho-pulmonary Allergic broncho-pulmonary Aspergilosis.Aspergilosis.
• Asthma.Asthma.
• Polyarteritis.Polyarteritis.
• Viral Pneumonia.Viral Pneumonia.
Unilateral Hyperlucent Lung.Unilateral Hyperlucent Lung.
• Swyer-James syndrome.Swyer-James syndrome.
• Pulmonary embolism.Pulmonary embolism.
• Pneumothorax.Pneumothorax.
• Obstructive Emphysema.Obstructive Emphysema.
Rapidly Clearing Alveolar InfiltrateRapidly Clearing Alveolar Infiltrate
• Hemorrhage.Hemorrhage.
• Pulmonary edema.Pulmonary edema.
• Aspiration.Aspiration.
• Pneumococcal pneumonia.Pneumococcal pneumonia.
Cavitating PneumoniaCavitating Pneumonia
• Staphylococcus.Staphylococcus.
• Streptococcus.Streptococcus.
• Mycobacterium Tuberculosis.Mycobacterium Tuberculosis.
• Gram negative (Klebsiella).Gram negative (Klebsiella).
Middle Mediastinal MassesMiddle Mediastinal Masses
• Lymphadenopathy.Lymphadenopathy.
• Aneurysm.Aneurysm.
• Esophageal Duplication.Esophageal Duplication.
• Bronchogenic cysts.Bronchogenic cysts.
Masses with Air BronchogramMasses with Air Bronchogram
• Lymphoma.Lymphoma.
• Alveolar cell carcinoma.Alveolar cell carcinoma.
• Pseudolymphoma (MALToma – Mucosa Pseudolymphoma (MALToma – Mucosa associated pseudolymphoma)associated pseudolymphoma)
Hilar LymphadenopathyHilar Lymphadenopathy
• Sarcoidosis.Sarcoidosis.
• Tuberculosis.Tuberculosis.
• Lymphoma.Lymphoma.
• Bronchogenic Carcinoma.Bronchogenic Carcinoma.
• MetastasisMetastasis.
Cavities Containing MassesCavities Containing Masses
• Aspergillosis.Aspergillosis.
• Cavitating bronchogenic carcinoma.Cavitating bronchogenic carcinoma.
• Tuberculosis.Tuberculosis.
• Hydatid Cyst.Hydatid Cyst.
Infiltrates with EffusionInfiltrates with Effusion
• Staph Pneumonia.Staph Pneumonia.
• Strep Pneumonia.Strep Pneumonia.
• TB.TB.
• Pulmonary Infarct.Pulmonary Infarct.
Mass + ipsilateral Mass + ipsilateral LymphadenopathyLymphadenopathy
• Bronchogenic Carcinoma.Bronchogenic Carcinoma.
• Lymphoma.Lymphoma.
• TB.TB.
Solitary Pulmonary NoduleSolitary Pulmonary Nodule
• Bronchogenic Carcinoma.Bronchogenic Carcinoma.• Hamartoma.Hamartoma.• Histoplasmoma.Histoplasmoma.• TB Granuloma.TB Granuloma.• Bronchial Adenoma.Bronchial Adenoma.• Solitary Metastasis.Solitary Metastasis.• Round Pneumonia.Round Pneumonia.• Rounded atelectasis.Rounded atelectasis.
Pleural EffusionPleural Effusion
• CHF.CHF.• Metastasis.Metastasis.• Pancreatitis.Pancreatitis.• Pulmonary embolism.Pulmonary embolism.• Trauma.Trauma.• Empyema.Empyema.• Collagen Vascular Disease.Collagen Vascular Disease.• Ovarian Tumor (Meig’s Syndrome).Ovarian Tumor (Meig’s Syndrome).• Chylothorax.Chylothorax.
LT sided Pleural EffusionLT sided Pleural Effusion
• Boerhaave’s Syndrome.Boerhaave’s Syndrome.
• Dissecting Aortic aneurysm.Dissecting Aortic aneurysm.
• Pancreatitis.Pancreatitis.
• Distal thoracic duct rupture.Distal thoracic duct rupture.
Multiple Small CalcificationsMultiple Small Calcifications
• Histoplasmosis.Histoplasmosis.
• Silicosis.Silicosis.
• Chicken pox pneumonia.Chicken pox pneumonia.
• Metastatic calcification.Metastatic calcification.
• Secondary Amyloidosis.Secondary Amyloidosis.
• Alveolar Microlithiasis.Alveolar Microlithiasis.
Posterior Mediastinal MassesPosterior Mediastinal Masses
• Neurogenic Tumors.Neurogenic Tumors.
• Lymphadenopathy.Lymphadenopathy.
• Extra-medullary hematopoesis.Extra-medullary hematopoesis.
Mediastinal AdenopathyMediastinal Adenopathy
• Bronchogenic Carcinoma.Bronchogenic Carcinoma.
• Lymphoma.Lymphoma.
• TBTB
• Metastasis.Metastasis.
• Sarcoid.Sarcoid.
Lung disease & Rib DestructionLung disease & Rib Destruction
• Bronchogenic CA – Pancoast tumor.Bronchogenic CA – Pancoast tumor.
• Actinomycosis.Actinomycosis.
• Blastomycosis.Blastomycosis.
• Multiple myeloma.Multiple myeloma.
Pleural CalcificationPleural Calcification
• Old TB empyema.Old TB empyema.
• Asbestos exposure.Asbestos exposure.
• Hemothorax.Hemothorax.
Masses in Cardio-phrenic AngleMasses in Cardio-phrenic Angle
• Sequestration.Sequestration.
• Diaphragmatic hernia.Diaphragmatic hernia.
• Pericardial cyst.Pericardial cyst.
Unilateral Pulmonary EdemaUnilateral Pulmonary Edema
• Aspiration.Aspiration.
• Disease in other lung e.g. COPD.Disease in other lung e.g. COPD.
• Postural.Postural.
• Rapid expansion of pneumothorax.Rapid expansion of pneumothorax.
Reverse Pulmonary EdemaReverse Pulmonary Edema
• Eosinophilic lung disease, e.g. Eosinophilic lung disease, e.g. Loeffler’s .Loeffler’s .
• Sarcoidosis.Sarcoidosis.
• Pulmonary Contusions.Pulmonary Contusions.