Table 4.
Clinical, laboratory and imaging findings, and prognosis/treatment of miscellaneous causes of chronic airspace disease
Causes of chronic airspace disease/ General category | Clinical information | Laboratory findings | Imaging findings | Prognosis and treatment |
Lipoid pneumonia/ Miscellaneous | Usually elderly individuals; History of chronic inflammation in primary (endogenous) form; History of chronic constipation and aspiration in the secondary (exogenous) form | Chronic consolidative and GGOs; Nodules and masses; More in the dependent portions of the lungs; May or may not have fat attenuation | Biopsy may be needed in lipid poor cases to exclude malignancy | |
Alveolar hemorrhage/ Miscellaneous | May have history of vasculitides, connective tissue disorders, or coagulation disorders | GGO or consolidation in the acute phase; GGO and interlobular septal thickening in subacute phase; May develop fibrosis if recurrent or chronic; Opacities may show subtle or major changes in appearance (migratory) | Supportive treatment; Treatment of underlying disease | |
PAP/ Miscellaneous | Due to abnormal intra-alveolar accumulation of surfactant-like material; More common in smokers | Crazy-paving which is due to combination of GGO and smooth interlobular septal thickening; This finding is very suggestive but not pathognomonic; Usually bilateral and extensive, with more severe involvement of the lower lobes | Whole-lung bronchoalveolar lavage to remove alveolar material; Variable prognosis, ranging from improvement with treatment to a chronic and terminal course. |
GGO: Ground glass opacity; PAP: Pulmonary alveolar proteinosis.