CASE 106 58-year-old woman complaining of progressive shortness of breath Unenhanced chest CT axial (Figs. 106.1A, 106.1B, 106.1C, 106.1D; lung window) and coronal (Figs. 106.1E; lung window) images demonstrate bilateral symmetric ground glass and smooth reticular opacities diffusely throughout the lungs without a zonal predilection. The involved regions of lung parenchyma are sharply demarcated from adjacent normal lung. This combination of ground glass with reticular opacities creates a pattern of disease called “crazy paving.” Note the preservation of lung volume and the absence of lymphadenopathy and pleural effusion. Pulmonary Alveolar Proteinosis • Edema • Infection • Organizing Pneumonia • Neoplasia • Other
Clinical Presentation
Radiologic Findings
Diagnosis
Differential Diagnosis
Cardiogenic
ARDS
Acute Interstitial Pneumonia (AIP)
Pneumocystis jiroveci Pneumonia
Viral Pneumonia
Mycoplasma Pneumonia
Bacterial Pneumonia
Bronchiolitis Obliterans Organizing Pneumonia (BOOP)/Cryptogenic Organizing Pneumonia (COP)
Adenocarcinoma in-situ
Hemorrhage
Pulmonary Alveolar Proteinosis
Sarcoidosis
Non-Specific Interstitial Pneumonia (NSIP)
Lipoid Pneumonia
Subacute Radiation Therapy–Related Pneumonitis (XRT)
Discussion
Background
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