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Accuracy of High-Resolution CT in the Diagnosis of Diffuse Lung Disease: Effect of Predominance and Distribution of Findings

Baskaran Sundaram1, Barry H. Gross1, Fernando J. Martinez2, Eugene Oh1,3, Nestor L. Müller4, Matt Schipper1,5 and Ella A. Kazerooni1

1 Department of Radiology, University of Michigan Health System, Cardiovascular Center, Rm. 5481, 1500 E Medical Center Dr., Ann Arbor, MI 48109-5868.
2 Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI.
3 Present address: Valley Radiologists/SDI, Ltd., Glendale, AZ.
4 Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.
5 Present address: Innovative Analytics, Kalamazoo, MI.


Figure 1
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Fig. 1 61-year-old woman with predominant CT finding of honeycombing (arrow), which is highly specific for usual interstitial pneumonitis. Findings at surgical lung biopsy were consistent with usual interstitial pneumonitis.

 

Figure 2
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Fig. 2 60-year-old woman with predominant CT finding of bilateral multiple thin-walled lung cysts (white arrow) uniformly distributed from lung apex to base. Incidental small left pneumothorax (black arrow) is evident. Left renal and left adrenal gland masses were found and surgically removed. Both masses were histologically proven angiomyolipoma. Lung changes were presumed to be due to lymphangiomyomatosis.

 

Figure 3
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Fig. 3 51-year-old man with CT finding of nodular peribronchovascular interstitial thickening (arrow). Results of transbronchial biopsy were positive for multiple epithelioid granuloma in alveolar parenchyma and bronchial wall, suggesting sarcoidosis. Results of special stains for acid-fast bacilli and fungi were negative.

 

Figure 4
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Fig. 4 56-year-old woman with predominant CT finding of ground-glass opacification. Centrilobular ground-glass opacities are diffusely distributed in craniocaudal direction with no other predominant findings recorded. Histologic diagnosis was hypersensitivity pneumonitis.

 

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