Learning objectives
Aim of this presentation is to show differential diagnosis of micro nodules in lungscharacterizedby their intensity and by their pattern.
Background
Nodular changes are multiple round opacities,
in most cases of a diameter of 0.5 to 5mm
Precisely diagnosed with CT scan (superposition on X ray)
Nodular changes can be:
Milliar – fom 0.1-0.5mm lat.-millium
Micronodular- from 0.5 to 2 mm,
the size of the grain of the spring,
Macronodular - 2 to 5 mm
There are also round changes (5mm to 3cm) and tumor shadows (over 3cm)
Nodules are further characterized by their edges (clear or unclear),
the intensity of the shadow (semitransparent,
mycotic,
spot)...
Findings and procedure details
A well-taken history is necessary for finding etiological causes of nodular changes including professional (pneumoconiosis) history,
and clinical and laboratory data.
When interpreting the X ray image,
pay attention to the possible enlargement of the lymph nodes of the hilum and the mediastinum (unilateral,
bilateral),
pleural reaction,
changes in heart size,
and configuration of the arteries of the heart-shaped shadow.
HRCT - crucial for definitive diagnosis,
precise information on nodules (intensity,
distribution),
interstitial,
parenchyma.
CT distribution of the nodules on the basis of the part...
Conclusion
Only with good anamnesis taken from patient with all known occupational exposure,
associated illnesses and with good CT examination (witch is now gold standard) we should be able to get right diagnosis of micronodular changes in lungs.When possible it should be always done comparison with previous recordings and should be always payed attention to localization,
distribution,
size and looked for secondary metastases in other organs and lymph nodes of mediastinum.
References
Thoracic Radiology: The Requisites (Requisites in Radiology)2nd EditionbyTheresa C.
McLoud MD(Author)