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Diagnostic Value of High-Resolution CT in the Evaluation of Chronic Infiltrative Lung Disease in Children

Stephanie Vrielynck1, Tania Mamou-Mani2, Sophie Emond2, Pierre Scheinmann1, Francis Brunelle2 and Jacques de Blic1

1 Service de Pneumologie et Allergologie Pédiatriques, Hôpital Necker Enfants Malades, Assistance Publique des Hôpitaux de Paris, 149 rue de Sèvres, 75015 Paris, France.
2 Service de Radiologie Pédiatriques, Hôpital Necker Enfants Malades, Assistance Publique des Hôpitaux de Paris, Paris, France.


Figure 1
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  		Fig. 1A —Typical pulmonary alveolar proteinosis in 10-month-old boy. High-resolution CT sections of upper (A), middle (B), and lower (C) areas of lung. Note diffuse ground-glass attenuation with superimposed reticular pattern and typical airspace consolidation in posterior and peripheral zones. Important thickening of fissure is seen.

 

Figure 2
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  		Fig. 1B —Typical pulmonary alveolar proteinosis in 10-month-old boy. High-resolution CT sections of upper (A), middle (B), and lower (C) areas of lung. Note diffuse ground-glass attenuation with superimposed reticular pattern and typical airspace consolidation in posterior and peripheral zones. Important thickening of fissure is seen.

 

Figure 3
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  		Fig. 1C —Typical pulmonary alveolar proteinosis in 10-month-old boy. High-resolution CT sections of upper (A), middle (B), and lower (C) areas of lung. Note diffuse ground-glass attenuation with superimposed reticular pattern and typical airspace consolidation in posterior and peripheral zones. Important thickening of fissure is seen.

 

Figure 4
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  		Fig. 2A —Pulmonary alveolar proteinosis in 2-year-old girl. High-resolution CT sections through upper (A), middle (B), and lower (C) areas of lung. Note ground-glass opacification that is uniformly distributed throughout lungs, poorly thickened interlobular septa, and widespread micronodules. In this case, both radiologists made diagnosis of idiopathic pulmonary fibrosis.

 

Figure 5
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  		Fig. 2B —Pulmonary alveolar proteinosis in 2-year-old girl. High-resolution CT sections through upper (A), middle (B), and lower (C) areas of lung. Note ground-glass opacification that is uniformly distributed throughout lungs, poorly thickened interlobular septa, and widespread micronodules. In this case, both radiologists made diagnosis of idiopathic pulmonary fibrosis.

 

Figure 6
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  		Fig. 2C —Pulmonary alveolar proteinosis in 2-year-old girl. High-resolution CT sections through upper (A), middle (B), and lower (C) areas of lung. Note ground-glass opacification that is uniformly distributed throughout lungs, poorly thickened interlobular septa, and widespread micronodules. In this case, both radiologists made diagnosis of idiopathic pulmonary fibrosis.

 

Figure 7
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  		Fig. 3A —Typical idiopathic pulmonary fibrosis in 14-year-old boy. High-resolution CT sections through upper (A), middle (B), and lower (C) lobes. Note diffuse ground-glass attenuation and honeycomb patterns (combination of subpleural cyst and thickened interlobular septa), fissural thickening, and cystic area on left.

 

Figure 8
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  		Fig. 3B —Typical idiopathic pulmonary fibrosis in 14-year-old boy. High-resolution CT sections through upper (A), middle (B), and lower (C) lobes. Note diffuse ground-glass attenuation and honeycomb patterns (combination of subpleural cyst and thickened interlobular septa), fissural thickening, and cystic area on left.

 

Figure 9
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  		Fig. 3C —Typical idiopathic pulmonary fibrosis in 14-year-old boy. High-resolution CT sections through upper (A), middle (B), and lower (C) lobes. Note diffuse ground-glass attenuation and honeycomb patterns (combination of subpleural cyst and thickened interlobular septa), fissural thickening, and cystic area on left.

 

Figure 10
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  		Fig. 4A —Idiopathic pulmonary fibrosis in 5-month-old girl. Thin-section CT scans of upper (A), middle (B), and lower (C) zones. Note combination of smooth thickening of interlobular septa, ground-glass opacification, and most pseudoalveolar opacities in perihilar pattern. In this case, first radiologist made diagnosis of hemosiderosis and second radiologist made diagnosis of pulmonary alveolar proteinosis.

 

Figure 11
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  		Fig. 4B —Idiopathic pulmonary fibrosis in 5-month-old girl. Thin-section CT scans of upper (A), middle (B), and lower (C) zones. Note combination of smooth thickening of interlobular septa, ground-glass opacification, and most pseudoalveolar opacities in perihilar pattern. In this case, first radiologist made diagnosis of hemosiderosis and second radiologist made diagnosis of pulmonary alveolar proteinosis.

 

Figure 12
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  		Fig. 4C —Idiopathic pulmonary fibrosis in 5-month-old girl. Thin-section CT scans of upper (A), middle (B), and lower (C) zones. Note combination of smooth thickening of interlobular septa, ground-glass opacification, and most pseudoalveolar opacities in perihilar pattern. In this case, first radiologist made diagnosis of hemosiderosis and second radiologist made diagnosis of pulmonary alveolar proteinosis.

 

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