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    Lung patterns made easy (Proceedings) _ DVM 360

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    Lung Patterns Made Easy (Proceedings) - DVM 360

    Uploaded by

    dmantsio

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 3

    By Role Lung patterns made

    Associates
    easy (Proceedings)
    April 1, 2015
    Owners Robert Obrien, DVM, MS, DACVR

    Practice Manager

    Students
    The most important question to ask yourself
    is: Is the lung too opaque or too lucent?
    Technicians
    Lung disease

    Subscriptions The most important question to ask


    yourself is: Is the lung too opaque or too
    dvm360 Newsletter
    lucent? If the lung are diffusely or focally
    too opaque then use the pattern system
    dvm360 Magazine
    (below).

    Vetted Magazine Pattern method

    Firstline Magazine The pattern approach to interpreting lung


    lesions simpli es your life. For reasons of
    simplicity we will not discuss mixed
    Contact Us patterns. Clinically when faced with a mixed
    Fetch DVM360 Conference
    pattern, identify the most severe ( i.e.
    Terms and Conditions
    alveolar or nodular).
    Privacy
    Do Not Sell My Information normal variants causing
    increased lung opacity
    Expiration: mild interstitial pattern

    Underexposure: mild interstitial


    pattern

    © 2020 MJH Life Sciences™ and DVM 360. All Geriatric patients: mild bronchial
    rights reserved.
    and interstitial patterns

    Obesity: mild interstitial pattern

    Collies: heterotopic bone mimic


    nodules

    Nipples, ticks, dirt, and


    costochondral junctions: mimic
    pulmonary nodules.

    Alveolar

    This is the most mis- underdiagnosed


    pattern. The silhouette sign (=border
    effacement) is the hallmark radiographic
    sign of an alveolar disease. This manifest
    as the inability to see margins of heart,
    vessels or diaphragm. A particular form of
    the silhouette sign is the air bronchogram.
    This is the ability to see air in bronchial
    lumen surrounded by opaque lung. The
    analogy is “black tree branching in a snow
    storm”. The lobar sign indicates that the
    disease margins are limited precisely by the
    lung lobe margin and the disease seems to
    completely ll one lobe.

    Causes: (HELP ME acronym)


    Blood (Hemorrhage)

    Water (Edema)
    Cells  (neoplasia; Lymphoma in
    dogs, primary pulmonary
    neoplasia in cats)

    Pus (pneumonia; viral, bacterial


    or fungal)

    Atelectasis (detected by the


    Mediastinal shift when the alveoli
    are Empty)

    Bronchial

    The hall mark of this pattern is thickened


    bronchi. This may be due to in ltration with
    in ammatory cells or edema.

    Causes include:
    bronchitis

    dogs: bacterial > allergic


    (eosinophilic)

    cats: allergic > bacterial


    (Mycoplasma)

    Vascular

    Enlarged vessels the sole cause of


    increased opacity (see heart notes)

    Nodular interstitial

    These are soft tissue nodules or masses in


    the lung

    Causes
    Metastatic neoplasia

    mycotic pneumonia

    granuloma

    abscess

    hematoma, hematocoele   

    Unstructured interstitial

    This pattern is the most commonly over


    diagnosed pattern. It is very common as a
    normal variant due to expiration or
    underexposure, and seen in geriatric or
    obese patients. It requires a high degree of
    skill to differentiate variants from true
    disease.

    Causes
    Lymphoma

    nonalveolarized edema (edema in


    transition: forming or resolving)

    Left-side heart failure (see above)

    Vasculitis (see above)

    atypical allergic/infectious
    pneumonitis

     
    So a ow diagram for decision-making
    regarding pulmonary patterns is:

    Is there evidence of border effacement? 


                               If yes, è Alveolar

                                    No? ê

    Are the bronchial walls more opaque or


    thickened?                If yes, è  Bronchial

                                    No?

    Are there nodules or masses?


                                                     If yes, è
     Structured interstitial

                                    No?

                                    Then… è           


                                    Unstructured interstitial

    References

    O'Brien RT. Thoracic Radiology for the Small


    Animal Practitioner. Jackson, WY: Teton
    New Media; 2001;

    Related Content:
    Imaging

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