FRCR-RV-NOTES

“SYSTEMIC LUPUS ERYTHEMATOSUS”

“ This is a collagen vascular disease commonly affecting the lungs, characterised by the deposition of autoantibodies and immune complexes in tissues (usually idiopathic, may be drug induced). It is 10-times more common in women. Treatment is with steroids and immunosuppression. PLAIN FILM •  Pleural thickening (up to 50%, often painful) and pleural effusions. • …

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“PULMONARY ALVEOLAR MICROLITHIASIS”

“ Asymptomatic in 70% of patients (despite florid appearances on imaging!). Typically presents at age 30-50 years, more common in Turkey. PLAIN FILM •  Diffuse, dense miliary calcification, which may obscure borders with the mediastinum, diaphragm, etc. •  Sub-pleural cyst formation may give the pleura a lucent appearance on chest x-ray. CT •  Numerous bilateral …

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“SOLITARY PULMONARY NODULE”

“ In the absence of malignancy elsewhere, small nodules are risk stratified using the Fleischner Society guidelines.  Masses >4 cm are usually malignant.  PET is 96% sensitive for lung nodules >1 cm.  Nodules <2 cm are benign in about 80% of cases.  Features suggesting benignity include: •  Lack of interval growth over 2 years•  Calcification …

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THE ‘TREE IN BUD’ PATTERN

This is a non-specific pattern of tiny centrilobular nodules of soft tissue density attached to branches arising from a single stalk seen on HRCT. The branches and stalk represent dilated, thick-walled lobular bronchioles (normally too small to be seen) filled with mucous, pus, fluid or tumour cells. Causes include infection (bacterial, fungal or viral), congenital …

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“TUBERCULOSIS”

“ Due to inhaled Mycobacteria tuberculosis. This is very common worldwide. Initial infection in the naive host is known as primary TB; secondary/reactivation TB occurs due to immunocompromised status or reinfection. Miliary disease may occur with primary or secondary TB. PLAIN FILM •  Classic acute appearance is middle/lower lobe consolidation with ipsilateral lymph node enlargement and effusion. …

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SILTZBACH STAGING OF SARCOIDOSIS

“ 1.  Normal chest radiograph2.  Bilateral hilar lymph node enlargement3.  Bilateral hilar lymph node enlargement, parenchymal infiltration4.  Parenchymal infiltration5.  Parenchymal volume loss as a result of pulmonary fibrosis—20% get to stage 4 with irreversible fibrosis. ” For Radiology Cases, Discussion join: Radiology Made Easy on Facebook  Subscribe to our youtube channel for FRCR radiology case …

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CYSTIC BRONCHIECTASIS

“ A string or cluster of cyst-like bronchi, the most severe kind of bronchiectasis. Causes include post-infectious (e.g. pertussis and unilobar), post-obstruction and Mounier-Kuhn syndrome. Plain film/HRCT  •  Cysts in clusters or strings •  Air-fluid levels commonly seen within the cysts Cystic bronchiectasis. Chest x-ray demonstrating ring shadows in keeping with cystic bronchiectasis. ” For …

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