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Inhalational Diseases

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Abstract

This chapter describes the major pneumoconioses (silicosis, asbestosis, hypersensitivity pneumonitis, allergic bronchopulmonary aspergillosis (ABPA), and crack lung).

Keywords

  • Pneumoconiosis
  • Silicosis
  • Asbestosis
  • Hypersensitivity pneumonitis
  • Allergic bronchopulmonary aspergillosis (ABPA)
  • Crack lung

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References

  1. Nemec SF, Bankier AA, Eisenberg RL. Upper lobe-predominant diseases of the lung. AJR. 2013;200:W222–37.

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  2. Eisenberg RL. Clinical Imaging: An Atlas of Differential Diagnosis. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2010.

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  3. Eisenberg RL, Johnson NM, editors. Comprehensive Radiographic Pathology. 6th ed. St. Louis: Elsevier/Mosby; 2016.

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  4. Nemec SF, Bankier AA, Eisenberg RL. Lower lobe-predominant diseases of the lung. AJR. 2013;200:712–28.

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Fig. e14.1

Berylliosis. Diffuse small nodules (arrows) containing microcalcifications, which primarily involve the apical segment of the right lower lobe. (Courtesy of Pierre Alain Gevenois, MD, PhD, Brussels, Belgium.) [1] (TIF 1500 kb)

Fig. e14.2

Silicosis. Diffusely scattered centrilobular micronodules and multiple subpleural nodules (arrows) in the upper lobes [1] (TIF 1393 kb)

Fig e14.3

Silicosis. Prominence of interstitial markings, upward retraction of the hila, and bilateral calcific densities that tend to conglomerate in the upper lobes [2] (TIF 770 kb)

Fig e14.4

Silicosis. Progressive massive fibrosis produces nonsegmental areas of homogeneous opacity in both upper lobes [2] (TIF 878 kb)

Fig. e14.5

Silicosis. CT scan at the level of the aortic arch shows large, symmetric bilateral opacities with irregular margins (arrows), indicative of progressive massive fibrosis, as well as numerous small nodules and septal thickening (arrowheads) [5] (TIF 1136 kb)

Fig. e14.6

Coal workers’ pneumoconiosis. Ill-defined masses of fibrous tissue in the perihilar regions with extension to the right base [2] (TIF 874 kb)

Fig. e14.7

Coal workers’ pneumoconiosis. Progressive massive fibrosis produces conglomerate masses and adjacent small nodules. The arrowhead points to a thoracostomy tube that was placed in the left hemithorax for a pneumothorax [2] (TIF 1508 kb)

Fig. e14.8

Asbestosis. (a) Bilateral ground-glass opacities and subpleural fibrotic changes (arrows) that demonstrate basilar predominance (TIF 1485 kb)

Fig. e14.8

Asbestosis. (b) Bilateral ground-glass opacities and subpleural fibrotic changes (arrows) that demonstrate basilar predominance [4] (TIF 1456 kb)

Fig. e14.9

Asbestosis. Moderate thickening of interlobular septal (arrows) and peribronchial (arrowheads) structures in the nondependent subpleural parenchyma. On the left, there is a suggestion of subpleural honeycombing (curved arrow). The interlobar fissures are thickened, and there is aeration of the lung-pleural interface at sites of interstitial fibrosis, changes indicative of visceral pleural fibrosis [2] (TIF 552 kb)

Fig. e14.10

Asbestosis. Calcified pleural plaques along the lateral and posterior chest wall (open arrows) and adjacent to the heart (closed arrow) [2] (TIF 514 kb)

Fig. e14.11

Asbestos-related disease. (a) Focal (TIF 1406 kb)

Fig. e14.11

Asbestos-related disease. (b) widespread calcified pleural plaques (arrows) [5] (TIF 1658 kb)

Fig. e14.12

Acute hypersensitivity reaction (to calcium sulfate in gypsum exposure). Diffuse bilateral, upper lobe air-space nodules and ground-glass opacities, reflecting alveolitis without signs of lung fibrosis [1] (TIF 646 kb)

Fig. e14.13

Hypersensitivity pneumonitis (bird breeder’s lung). CT scan at the level of the right hemidiaphragm shows patchy areas of ground-glass opacity (arrows) that typically do not obscure the underlying vascular markings [2] (TIF 952 kb)

Fig. e14.14

Chronic hypersensitivity pneumonitis. (a) Patchy bilateral ground-glass infiltrates, small nodules, and bronchiectasis. (Courtesy of Gillian Lieberman, MD, Boston) (TIF 561 kb)

Fig. e14.14

Chronic hypersensitivity pneumonitis. (b) Patchy bilateral ground-glass infiltrates, small nodules, and bronchiectasis. (Courtesy of Gillian Lieberman, MD, Boston) (TIF 582 kb)

Fig. e14.15

Allergic bronchopulmonary aspergillosis. (a) Right-sided tubular, perihilar opacities (finger-in-glove sign; arrows), as well as increased intercostal spaces indicating overinflation (TIF 2924 kb)

Fig. e14.15

Allergic bronchopulmonary aspergillosis. (b) Distinct bronchiectasis and mucoid impaction (finger-in-glove sign; arrows) (TIF 2389 kb)

Fig. e14.15

Allergic bronchopulmonary aspergillosis. (c) Impacted mucus (arrows) due to hyphal masses within bronchi and bronchioles has high attenuation [1] (TIF 2250 kb)

Fig. e14.16

Allergic bronchopulmonary aspergillosis. (a) Initial scan shows multiple tubular areas of increased attenuation in the left upper lobe (TIF 1300 kb)

Fig. e14.16

Allergic bronchopulmonary aspergillosis. (b) Repeat study 2 months later shows cystic bronchiectasis in this region [2] (TIF 1341 kb)

Fig. e14.17

Crack cocaine addict. (a) Initial image shows a diffuse pattern of alveolar edema/hemorrhage (TIF 641 kb)

Fig. e14.17

Crack cocaine addict. (b) After steroid therapy, the chest radiograph appears normal (TIF 1562 kb)

Fig. e14.17

Crack cocaine addict. (c) Following another episode of smoking crack cocaine, there again is diffuse alveolar edema/hemorrhage (TIF 1399 kb)

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Eisenberg, R.L. (2020). Inhalational Diseases. In: What Radiology Residents Need to Know: Chest Radiology . Springer, Cham. https://doi.org/10.1007/978-3-030-16826-1_14

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  • DOI: https://doi.org/10.1007/978-3-030-16826-1_14

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