“Crazy-Paving” Pattern at Thin-Section CT of the Lungs: Radiologic-Pathologic Overview

Rossi, Santiago E.; Erasmus, Jeremy J.; Volpacchio, Mariano; Franquet, Tomás; Castiglioni, Teresa; McAdams, H. Page

doi:10.1148/rg.236035101

Cited by 275 publications

(179 citation statements)

References 40 publications

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“…Paraquat ingestion usually results in diffuse alveolar damage, but hyaline membranes were not present in a fatal case with intra-alveolar fibrosis [310]. Organising pneumonia has been Amiodarone [90,230,[233][234][235][236][237][238][239][240] Amphotericin B [241] Bleomycin [18,[242][243][244][245][246][247][248][249][250][251][252] Busulfan [230,253,254] Busulfan and cyclophosphamide [230] Carbamazepine [255,256]; in association with carbamazepine induced lupus [257] Cephalosporin (cefradin) [258] Chlorambucil [259] Doxorubicin Possible recall after radiation to the breast [260] Fluvastatin [261] Gold salts [262,263] Hexamethonium [264] Interferon-a [264,265] Interferon-a2b, pegylated interferon a2b [266] Interferon-a + cytosine arabinoside [267] Interferon + ribavirin [266] Interferon-b1a [268,…”

Section: Fungimentioning

confidence: 99%

Cryptogenic organising pneumonia

Jf¹

2006

Eur Respir J

485

466

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Organising pneumonia is defined histopathologically by intra-alveolar buds of granulation tissue, consisting of intermixed myofibroblasts and connective tissue. Although nonspecific, this histopathological pattern, together with characteristic clinical and imaging features, defines cryptogenic organising pneumonia when no cause or peculiar underlying context is found. Rapid clinical and imaging improvement is obtained with corticosteroid treatment, but relapses are common after stopping treatment.

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Section: Fungimentioning

confidence: 99%

Cryptogenic organising pneumonia

Jf¹

2006

Eur Respir J

485

466

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“…The radiographic findings are highly variable, nonspecific and can present as focal or diffuse air space process, mass-like lesions, ground glass opacities, reticulonodular pattern, mixed alveolar and interstitial opacities, crazy paving pattern or nodular lesions or thin-walled cysts (pneumatoceles) and pleural effusions may also be seen [15][16][17]. However, when present, areas of fat attenuations with values between -150 HU and -30 HU in consolidations/air space process is a characteristic feature of lipoid pneumonia [2,15,[18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Case Report of Lipoid Pneumonia: An Unusual Etiology of a Lung Cavity

Nandavaram¹,

Manta²

2018

Int J Respir Pulm Med

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Lipoid pneumonia is an uncommon non-infectious condition that results from the accumulation of lipids of animal, vegetable or mineral origin, in the lungs [1,2]. Most often it is a result of aspiration from altered swallowing or cough mechanism. Children with palatal abnormalities debilitated older adults or adults with neurological or gastrointestinal disorders are commonly affected [1,3,4]. Lipoid pneumonia should be considered as a differential for a lung cavity lesion, especially in patients at risk for aspiration. Such lesions can persist on long-term follow up. However, infection and malignancy should be ruled out.Here, we present an atypical and rare radiographic presentation of lipoid pneumonia, where in patient presented with complaints of shortness of breath and productive cough. Chest imaging showed air space disease in the RUL with a central cavity lesion. Transbronchial biopsy of the lesion demonstrated features of lipoid pneumonia and was felt to be secondary to his chronic aspiration. Infectious work up was negative. Despite being on strict aspiration precautions, follow up CT thorax remonstrated the cavity in the right upper lobe. Repeat biopsy of the lesion showed the features of lipoid pneumonia.Lipoid pneumonia is believed to be secondary to aspiration given his history of mental retardation and altered mental status. Patient was deemed to be a high-risk candidate for lung resection surgery given the altered mental status and contractures and is being clinically monitored.

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“…A crazy-paving appearance on chest HRCT can be observed in patients with PAP, pulmonary alveolar microlithiasis, adult T-cell leukemia/lymphoma, exogenous lipoid pneumonia, Pneumocystis jirovecii pneumonia, mucinous bronchioloalveolar carcinoma, sarcoidosis, organizing pneumonia and adult respiratory distress syndrome (7)(8)(9)(10)(11). We excluded the other possible causes of pulmonary edema, including congestive heart failure and PAP, and finally diagnosed the patient with pulmonary lymphedema with generalized lymphedema secondary to thoracic duct ligation.…”

Section: Anterior View Posterior Viewmentioning

confidence: 99%

Life-threatening Pulmonary Lymphedema Secondary to Thoracic Duct Ligation

et al. 2014

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We herein report an extremely rare adult case presenting with life-threatening pulmonary lymphedema secondary to generalized lymphedema. A 47-year-old woman with generalized lymphedema from her feet to below her chest, had undergone surgical ligation of the thoracic duct and bilateral pleurodesis for the treatment of intractable idiopathic chylothorax three years earlier. Chest computed tomography demonstrated bilateral ground-glass opacities, air-space consolidation and interlobular septal wall thickening, presenting as a crazypaving appearance predominantly on the gravity side. Bronchoalveolar lavage revealed marked lymphocytosis. She was treated with long-term oxygen therapy with noninvasive positive-pressure ventilation, followed by lymphovenous anastomoses of the lower extremities.

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“Crazy-Paving” Pattern at Thin-Section CT of the Lungs: Radiologic-Pathologic Overview

Cited by 275 publications

References 40 publications

Cryptogenic organising pneumonia

Cryptogenic organising pneumonia

Case Report of Lipoid Pneumonia: An Unusual Etiology of a Lung Cavity

Life-threatening Pulmonary Lymphedema Secondary to Thoracic Duct Ligation

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