Approach to High Resolution CT

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Lung Nodules

Perilymphatic Nodules


Random Nodules

  • May have pleural nodules
  • Miliary TB
  • Miliary fungal disease
  • Hematogenous metastasis


Centrilobular Nodules

  • Most peripheral nodule is 5-10 mm from pleura and fissure
  • May mimic random pattern, but no pleural nodules
  • Disease of small vessels or small airways
  • Hypersensitivity pneumonitis
  • Endobronchial spread of MAC or TB
  • Bronchiolitis either infectious or inflammatory
  • Endobronchial spread of BAC
  • Pneumoconiosis
  • COP
  • LCH
  • Pulmonary edema or vasculitis
  • Bronchopneumonia


Tree in Bud

  • Dilitation and impaction of centrilobular airways
  • Centered 5-10 mm from pleural surface
  • Most consistent with infection (viral, MAC, TB, etc)
  • Bronchiectasis or bronchitis
  • Cystic fibrosis with superimposed infection
  • Aspiration
  • ABPA
  • BAC

Interstitial Opacity