Noninfectious Inflammatory Lung Disease: Imaging Considerations and Clues to Differential Diagnosis

Abstract

Noninfectious inflammatory lung diseases translate into various CT appearances that are important in making the correct diagnosis.

Imaging Pulmonary Inflammation

“…Nemec et al recently described common CT findings and imaging clues for noninfectious inflammatory lung disease, summarized in part below (9).…”

Imaging of Large Airways Disorders

“…Characterized by necrotizing granulomas and vasculitis, GPA primarily affects small and medium-sized vessels [70]. Up to half of patients with GPA have tracheobronchial tree involvement, which rarely is the only manifestation of the disease [69].…”

“…Chest radiography may show a smooth stenosis of the airways and pulmonary opacities that indicate lung involvement. On CT, signs of large airway involvement include smooth or nodular circumferential thickening of the tracheobronchial wall that leads to a single stenosis or multiple stenoses [70][71][72] (Table 1). Irregular calcifications of the tracheal cartilage rings and bronchiectasis can occur [70][71][72].…”

“…Severe airway obstruction may lead to atelectasis. Pulmonary involvement produces parenchymal consolidations with ground-glass halos, nodules, and masses that often cavitate [70][71][72].…”

Corticosteroids in the Treatment of Severe Covid-19 Lung Disease: The Pulmonology Perspective From the First United States Epicenter

“…Early in the pandemic, it was recognized that the physiological behavior of COVID-19 lung disease is often distinct from that typically encountered in ARDS/DAD ( Gattinoni et al, 2020 ). To the trained eye of a pulmonologist, the thoracic imaging appearance of early COVID-19 lung disease is less reminiscent of corticosteroid-resistant ARDS/DAD and more reminiscent of corticosteroid-sensitive substrates such as organizing pneumonia (OP), acute eosinophilic pneumonia (AEP), and vasculitis ( Hani et al, 2020 , Nemec et al, 2013 ). Although both influenza and coronavirus infect respiratory epithelial cells, there is histopathological evidence from the 2003 severe acute respiratory syndrome coronavirus (SARS-CoV) epidemic to suggest that the former has a more dramatic propensity than the latter for catastrophic lung injury in the form of DAD ( Ng et al, 2006 ).…”