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Isolated Diffuse Ground-Glass Opacity in Thoracic CT: Causes and Clinical Presentations

Wallace T. Miller, Jr.1 and Rosita M. Shah

1 Both authors: Department of Radiology, University of Pennsylvania School of Medicine, 3400 Spruce St., Silverstein 1, Philadelphia, PA 19104.



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  		Fig. 1. —29-year-old HIV-positive man with Pneumocystis carinii pneumonia. High-resolution CT image through carina shows widespread ground-glass opacity uniformly distributed across lungs.

 


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  		Fig. 2. —36-year-old man with cytomegalovirus pneumonia following renal transplantation. High-resolution CT image through inferior hilum shows isolated diffuse ground-glass opacity widely spread across both lungs.

 


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  		Fig. 3. —65-year-old woman with respiratory syncytial virus pneumonia receiving chemotherapy for ovarian cancer. High-resolution CT image through carina shows extensive ground-glass opacity across both lungs. There also is nonspecific interstitial thickening in more dependent lungs bilaterally; however, ground-glass opacity remains dominant finding.

 


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  		Fig. 4. —75-year-old woman being treated for treated for promyelocytic leukemia and presenting with all-transretinoic acid syndrome of noncardiogenic edema. Thick-section CT image through carina shows widespread ground-glass opacities and small bilateral pleural effusions.

 


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  		Fig. 5. —37-year-old woman with methotrexate lung toxicity being treated for rheumatoid arthritis. High-resolution CT image through carina shows widespread isolated ground-glass opacities with lobular distribution forming mosaic pattern.

 


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  		Fig. 6. —29-year-old woman with hypersensitivity pneumonitis, slowly progressive dyspnea, and frequent exposure to birds. High-resolution CT scan of right upper lobe shows poorly defined centrilobular nodules of ground-glass opacity.

 


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  		Fig. 7. —72-year-old woman with desquamative interstitial pneumonia, slowly progressive dyspnea, and 40-pack-year history of smoking. High-resolution CT reveals uniform ground-glass opacity.

 


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  		Fig. 8. —26-year-old woman with nonspecific interstitial pneumonia, progressive dyspnea, and positive antinuclear antibodies. High-resolution CT of upper lobes reveals subpleural areas of ground-glass opacity.

 


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  		Fig. 9. —46-year-old woman with sarcoidosis who presented with dyspnea and had restrictive pulmonary function tests. High-resolution CT image through carina reveals ground-glass opacities composed of many faint centrilobular nodules widely distributed throughout lungs.

 


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  		Fig. 10. —53-year-old man with pulmonary alveolar proteinosis. Slowly progressive high-resolution CT image through carina shows presence of ground-glass opacities with slight fine intralobular interstitial thickening. This combination of ground-glass opacities and interstitial thickening has been termed "crazy paving."

 


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  		Fig. 11. —44-year-old man with cardiogenic edema and with acute onset of dyspnea and history of mitral stenosis. High-resolution CT image through great vessels shows geographic ground-glass opacity.

 


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  		Fig. 12. —60-year-old man with diffuse alveolar hemorrhage and with acute onset of dyspnea and history of Wegener's granulomatosis. High-resolution CT image through right upper lobe bronchus reveals randomly distributed ground-glass opacities.

 

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