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Acute Parenchymal Lung Disease in Immunocompetent Patients

Diagnostic Accuracy of High-Resolution CT

Noriyuki Tomiyama1,2, Nestor L. Müller1, Takeshi Johkoh2, Osamu Honda2, Naoki Mihara2, Takenori Kozuka2, Seiki Hamada2, Hironobu Nakamura2, Masanori Akira3 and Kazuya Ichikado4

1 Department of Radiology, Vancouver General Hospital and University of British Columbia, 855 W. 12th Ave., Vancouver, B. C., V5Z 1M9, Canada.
2 Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
3 Department of Radiology, National Kinki Chuo Hospital for Chest Disease, 1180 Nagasone-cho, Sakai, Osaka, 591-8025, Japan.
4 First Department of Internal Medicine, Kumamoto University School of Medicine, 1-1-1 Honjo, Kumamoto, 860-0811, Japan.



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  		Fig. 1. —Bacterial pneumonia in 78-year-old woman. High-resolution CT scan (1-mm collimation) at level of truncus basalis of left lower lobe shows areas of air-space consolidation (arrow), ground-glass attenuation in segmental distribution, and centrilobular nodules (arrowhead).

 


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  		Fig. 2. —Mycoplasmal pneumonia in 44-year-old man. High-resolution CT scan (1-mm collimation) at level of tracheal carina reveals area of ground-glass attenuation (white arrow) and centrilobular nodules (black arrow). Note heterogeneous involvement of secondary pulmonary lobules.

 


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  		Fig. 3. —Acute interstitial pneumonia in 58-year-old woman. High-resolution CT scan (2-mm collimation) through superior segment of left lower lobe shows extensive area of ground-glass attenuation and traction bronchiectasis (solid arrow). Note intralobular reticular opacities (arrowhead) and traction bronchiectasis. Also noted is small pneumothorax (open arrow) on right side.

 


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  		Fig. 4. —Hypersensitivity pneumonitis in 48-year-old woman. High-resolution CT scan (1.5-mm collimation) at level of tracheal carina reveals centrilobular nodules (arrow) and areas of ground-glass attenuation.

 


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  		Fig. 5. —Acute eosinophilic pneumonia in 48-year-old man. High-resolution CT scan (2-mm collimation) through left basal segment shows area of ground-glass attenuation (long arrow) and interlobular septal thickening (short arrow). Also noted are thickening of bronchial walls and interlobar fissures. Small bilateral pleural effusions are present but are difficult to see on lung windows.

 


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  		Fig. 6. —Pulmonary hemorrhage in 39-year-old woman. High-resolution CT scan (1-mm collimation) targeted to right lung base reveals heterogeneous involvement of lung parenchyma by pulmonary hemorrhage resulting in areas of ground-glass attenuation (large arrow), air-space consolidation (small arrow), and sparing of adjacent lobules. Note mild interlobular septal thickening.

 

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