Australian Regenerative Medicine Institute

Category: Multinodular Disease

Multinodular Disease: Conclusion

LIP is most often seen in patients with underlying immunologic abnormalities, especially Sjogren syndrome and AIDS, and is characterized histologically by diffuse hyperplasia of bronchus-associated lymphatic tissue, resulting in a diffuse, polyclonal lymphoid cell infiltrate surrounding the airways and expanding the lung intersti-tium., As reported by Johkoh et al, in a study of 22 patients…

Multinodular Disease: Discussion

Those cases in which centrilobular nodules are present in patients in the absence of tree-in-bud opacities constitute the last part of this CT scan algorithm (Table 1). Included in this category are a variety of diseases or “mixed” entities that have in common localization to the centrilobular portion of the secondary lobule. This includes diseases…

Multinodular Disease: Results

While classically described in patients with an endobronchial spread of tuberculosis, in fact, tree-in-bud opacities can be identified in virtually any type of infectious bronchiolitis. This includes Mycobacterium tuberculosis, Mycobacterium avium-intra-cellulare, bacterial, viral, and fungal infections, and allergic bronchopulmonary mycosis. This pattern is also frequently encountered in patients with AIDS in whom recurrent episodes of…

Multinodular Disease: Steps

Group 2: In distinction with the patterns described in patients in group 1, group 2 includes those patients in whom no or very few nodules are perifis-sural or subpleural in distribution. Anatomically, these nodules are grouped together as being centri-lobular in distribution. By definition, these entities primarily involve centrilobular bronchioles and/or their accompanying pulmonary artery…

Multinodular Disease: Treatment

A basilar predominance is typically noted due to preferential blood flow to the lung bases. Individual nodules may have “feeding vessels” consistent with their hematogenous origin. On HRCT scans, a connection between nodules and the adjacent pulmonary vessels (ie, the mass-vessel sign) may be seen in approximately 75% of cases. Nodules may also be either…

Multinodular Disease: Study

The most important differential diagnoses for this pattern of disease are silicosis and coal worker pneumoconiosis. In both of these occupational diseases, perilymphatic nodules are the primary abnormality, typically involving the mid and upper lung fields. While these entities may simulate the appearance of sarcoidosis, they are usually easily diagnosed when correlated with clinical history….

Multinodular Disease: Definition

Group 1: Those cases in which a striking proportion of nodules demonstrate pleural or perifissural involvement characterize nodules as predominantly perilymphatic or lymphohematogenous in origin, constituting a separate arm of the algorithm (Table 1). The explanation for this pattern lies in the greater density of lymphatic channels seen in the interlobular septa and subpleural regions,…

Multinodular Disease: Morphologic Characterization

Diseases that are primarily hematogenous in origin, such as miliary infections or hematogenous metasta-ses, give rise to nodules that are randomly distributed throughout the secondary lobule, with the greatest profusion in the lung bases (Fig 3). These patterns are clearly separate from nodules that result from inhalational disorders such as occur in patients with endobronchial…

Multinodular Disease

For the purposes of this report, multinodular disease will be defined in a patient in which there are too many nodules to easily count on routine CT scan studies, with most of these nodules measuring < 1 cm in diameter. While the most common cause of multiple pulmonary nodules is metastatic disease, it is apparent…