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High-resolution CT image showing ground-glass opacities in the periphery of both lungs in a patient with COVID-19 (red arrows). The adjacent normal lung tissue with lower attenuation appears as darker areas. Ground-glass opacity (GGO) is a finding seen on chest x-ray (radiograph) or computed tomography (CT) imaging of the lungs.
Interstitial lung disease (ILD), or diffuse parenchymal lung disease (DPLD), [3] is a group of respiratory diseases affecting the interstitium (the tissue) and space around the alveoli (air sacs) of the lungs. [4] It concerns alveolar epithelium, pulmonary capillary endothelium, basement membrane, and perivascular and perilymphatic tissues. It ...
Zone 4 can be seen at the lung bases at low lung volumes or in pulmonary edema. Pulmonary interstitial pressure (Pi) rises as lung volume decreases due to reduced radial tethering of the lung parenchyma. Pi is highest at the base of the lung due to the weight of the above lung tissue.
Underexpansion can also cause interstitial markings due to parenchymal crowding, which can mimic the appearance of interstitial lung disease. Enlargement of the right descending pulmonary artery can indirectly reflect changes of pulmonary hypertension, with a size greater than 16 mm abnormal in men and 15 mm in women. [6]
The differential diagnosis includes other types of lung disease that cause similar symptoms and show similar abnormalities on chest radiographs. Some of these diseases cause fibrosis, scarring or honeycomb change. The most common considerations include: chronic hypersensitivity pneumonitis; non-specific interstitial pneumonia; sarcoidosis
Pneumatosis is the abnormal presence of air or other gas within tissues. [1] In the lungs, emphysema involves enlargement of the distal airspaces, [2] and is a major feature of chronic obstructive pulmonary disease (COPD). Other pneumatoses in the lungs are focal (localized) blebs and bullae, pulmonary cysts and cavities.
Preservation of lung volumes in the presence of increased interstitial markings is a radiographic hallmark of LAM that helps distinguish it from most other interstitial lung diseases, in which alveolar septal and interstitial expansion tend to increase the lung's elastic recoil properties and decreased lung volumes.
Overall, about 50% develop permanent pulmonary abnormalities, and 5 to 15% have progressive fibrosis of the lung parenchyma. Sarcoidosis of the lung is primarily an interstitial lung disease in which the inflammatory process involves the alveoli, small bronchi, and small blood vessels. [ 29 ]