To show the most frequent changes in aged lung and to distinguish the physiological appearance of ageing lung from pathologic findings in chest CT imaging.

Pulmonary aging is characterized by structural and functional changes of lungs in elderly people (>65years). Given the constant increase of life expectancy, it's very important to distinguish para-physiological findings (proper of lung aging) from the ones actually due to pulmonary pathologies. According to the latest estimates and demographic projections, the elderly population (> 60aa) is destined to grow and reach, in 2050, about 40% of the European population [1]. It will, therefore, be very important to be able to recognize the appearance of an "old...

From our database, we selected chest-CTs of people older than 65 years. We excluded pathological CTs (like fibrosis lungs, massive emphysema, oncologic patients) and chose the ones with more important illustrative images in reference to aging changes. The main changes occur in musculoskeletal structures, lung parenchyma and airways (table 1). Changes in musculoskeletal structures involve: • narrowing of the intervertebral disk spaces that causes kyphosis of the spine and reduction of inspiratory and expiratory respiratory muscle strength. The main alterations in the lungs are: •...

The described patterns are findings to be considered para-physiological and a reflection of the normal presentation spectrum of the old lung. The knowledge, the ability to recognize these characteristics and their correct interpretation are essential in preventing further diagnostic tests or follow-up in patients with stable clinical conditions. It is essential to be able to define what is normal in elderly patients, given the increase of average life.

Monica Palermo Resident doctor -Radiology I , Department of Medical - Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy. [email protected]

[1] http://www.un.org/esa/population/publications/worldageing19502050/ [2] Schröder T, Storbeck B, Rabe K, Weber C. The Aging Lung: Clinical and Imaging Findings and the Fringe of Physiological State. RöFo - Fortschritte Auf Dem Gebiet Der Röntgenstrahlen Und Der Bildgeb Verfahren 2015;187:430–9. doi:10.1055/s-0034-1399227. [3] Culham EG, Jimenez HA, King CE. Thoracic kyphosis, rib mobility, and lung volumes in normal women and women with osteoporosis. Spine (Phila Pa 1976) 1994;19:1250–5. [4] Lowery EM, Brubaker AL, Kuhlmann E, Kovacs EJ. The aging lung. Clin Interv Aging 2013;8:1489–96. doi:10.2147/CIA.S51152. [5] Panda A, Arjona...