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Interstitial Lung Disease: A Picture Book


This is an expanded version of material presented in earlier chapters. Interstitial disease is a difficult challenge for both radiologists and clinicians.

Figure S2.1

Normal

Figure S2.2

Comments

Note that the pulmonary vessels are the only structures seen within the air-filled lung. They branch, taper, and are barely visible as they reach the pleura. Bronchi are barely visible beyond the inner half of the lung.

Ground-Glass Opacification (Synonyms: foggy, hazy, and semiopaque )

Figure S2.3

Comments

This is like looking at the anatomy through a frosted shower door or frosted glass. The lung is an intermediate shade of gray, but the pulmonary vessels are visible within the gray areas. The diminished aeration may be due to (1) decreased air in the alveoli caused by partial alveoli filling, (2) decreased air in the alveoli caused by thickened interstitium encroaching on the alveoli, or (3) decreased air in the alveoli due to hypoventilation and atelectasis.

Causes

    • atelectasis

    • aspiration pneumonitis

    • infection, such as pneumocystis

    • edema, acute respiratory distress syndrome (ARDS)

    • pulmonary hemorrhage

    • idiopathic (e.g., desquamative interstitial pneumonitis, chronic organizing pneumonia)

Reticular (Synonyms: linear and irregular )

Figure S2.4

Comments

Acute or chronic thickening of the interlobular septa or the bronchovascular bundles causes linear or lace-like thickening. This may be smooth or irregular.

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