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Chest Imaging Differential Diagnoses

 
Acute Airspace Disease
1.   Pulmonary  edema
2.   Pneumonia
3.   Aspiration
4.   Hemorrhage
Anterior  Mediastinal Masses
1.   Thymoma
2.   Teratoma
3.   Substernal thyroid
4.   Lymphoma
Opacified Hemithorax
1.   Atelectasis
2.   Effusion
3.   Pneumonia
4.   Post-pneumonectomy
Chronic Airspace Disease
1.   Alveolar  cell ca         
2.   Alveolar  sarcoid       
3.   Lymphoma    
4.   Alveolar  proteinosis
Large Cavitary Lung Lesions
1.   Abscess
2.   Carcinoma
3.   TB
Bibasilar Interstitial Disease
1.   Bronchiectasis
2.   Aspiration
3.   DIP
4.   Asbestosis
5.   Sarcoidosis
6.   Scleroderma 
Micronodular Lung Disease
1.   Mets
2.   Sarcoid
3.   Pneumoconiosis
4.   Miliary TB
Pulmonary Fibrosis
1.   Pneumoconiosis
2.   Interstitial  Pneumonia
3.   Granulomatous  disease
4.   Neoplastic  disease
5.   Idiopathic  fibrosis
6.   Collagen  vascular disease
Small Cavitary Lung Lesions
1.   Septic  emboli
2.   Rheumatoid  nodules
3.   Squamous or  transitional cell mets
4.   Wegener’s  Granulomatosis
Lymphangitic Spread to the Lungs
1.   Lung ca
2.   Breast ca
3.   Stomach ca
4.   Pancreas ca
5.   Laryngeal  ca
6.   Cervical ca
Multiple Lung Nodules
1.   Mets
2.   Wegener’s  granulomatosis
3.   Rheumatoid  nodules
4.   AVMs
5.   Septic  emboli
Shifting Infiltrates
1.   Loeffler’s syndrome
2.   ABPA
3.   Asthma
4.   Polyarteritis
5.   Viral pneumonia
Unilateral Hyperlucent Lung
1.   Swyer James  syndrome
2.   Pulmonary  embolism
3.   Pneumothorax
4.   Obstructive  emphysema
Rapidly Clearing Airspace Disease
1.   Pneumococcal  pneumonia
2.   Hemorrhage
3.   Pulmonary  edema
4.   Aspiration
Cavitating Pneumonia
1.   Staph
2.   Strep
3.   TB
4.   Gram  negative (klebsiella)
Middle Mediastinal Masses
1.   Lymphadenopathy
2.   Aneurysms
3.   Esophageal  duplication
4.   Bronchogenic  cysts
Masses with Air Bronchograms
1.   Lymphoma
2.   Alveolar cell ca
3.   Pseudolymphoma (Maltoma)
Cavities Containing Masses
1.   Aspergillosis
2.   Cavitating  bronchogenic ca
3.   Hydatid  cyst
4.   Tuberculosis 
Infiltrates with Effusion
1.   Staph  pneumonia
2.   Strep  pneumonia
3.   TB
4.   Pulmonary  infarct
“Mass”+ ipsilateral adenopathy
1.   Bronchogenic  ca
2.   Lymphoma
3.   TB
Solitary Pulmonary Nodule
1.   Bronchogenic  ca
2.   Hamartoma
3.   Histoplasmoma
4.   TB  granuloma
5.   Bronchial  adenoma
6.   Solitary  met
7.   Round  pneumonia
8.   Rounded  atelectasis
Pleural Effusion
1.   CHF
2.   Mets
3.   Pancreatitis
4.   Pulmonary  embolism
5.   Trauma
6.   Empyema
7.   Collagen vascular
8.   Ovarian tumor (Meig’s Syndrome)
9.   Chylothorax
Multiple Small Calcifications
1.   Histoplasmosis
2.   Silicosis
3.   Chicken pox  pneumonia
4.   Pulmonary  ossification 2° MS
5.   Alveolar microlithiasis
Posterior  Mediastinal Masses
1.   Neurogenic tumors
2.   Lymphadenopathy
3.   Extramedullary  hematopoiesis
Mediastinal Adenopathy
1.   Bronchogenic  ca
2.   Lymphoma
3.   TB
4.   Mets
5.   Sarcoid
Lung Disease & Rib Destruction
1.   Bronchogenic  ca, i.e. Pancoast tumor
2.   Actinomycosis
3.   Blastomycosis
4.   Multiple  myeloma                
Pleural Calcification
1.   Old TB  empyema
2.   Asbestos  exposure
3.   Hemothorax
“Masses” in Cardiophrenic Angle
1.   Sequestration
2.   Diaphragmatic  hernia
3.   Pericardial  cyst
Unilateral Pulmonary Edema
1.   Aspiration
2.   Disease in  other lung, e.g. COPD
3.   Postural
4.   Rapid  expansion of PTX
Reverse Pulmonary Edema
1.   Eosinophilic  lung disease, e.g. Loeffler’s
2.   Sarcoid
3.   Pulmonary  contusions