Table 5.
Key imaging findings and imaging signs in chronic airspace disease
Imaging finding/sign | Cause |
Imaging signs | Halo sign: Fungal infection including angio-invasive pulmonary aspergillosis, pulmonary tuberculosis, lung adenocarcinoma, organizing pneumonia, granulomatosis with polyangiitis |
Reverse halo sign: Fungal infection including angio-invasive aspergillosis, organizing pneumonia, granulomatosis with polyangiitis, pulmonary tuberculosis, alveolar sarcoidosis | |
1-2-3 sign (right paratracheal and bilateral hilar lymphadenopathy): Alveolar sarcoidosis | |
Crazy paving: Pulmonary alveolar proteinosis, pulmonary hemorrhage, chronic eosinophilic pneumonia, organizing pneumonia, alveolar sarcoidosis | |
Pseudocavitation: Lung adenocarcinoma | |
Fried egg sign: Lung adenocarcinoma | |
Fissural retraction: Lung adenocarcinoma | |
Distribution | Upper lung: Sarcoid, chronic eosinophilic pneumonia (mid and upper), tuberculosis |
Lower lung: Lipoid pneumonia, organizing pneumonia (mid and lower) | |
Ground glass vs consolidation | Ground-glass opacity: Adenocarcinoma, pulmonary hemorrhage |
Mixed: Adenocarcinoma, organizing pneumonia, angio-invasive aspergillosis | |
Consolidation: Invasive mucinous adenocarcinoma, lymphoma, PTLD | |
Presence of cavitary lesion | Pulmonary tuberculosis |
Granulomatosis with polyangiitis and other vasculitis | |
Fungal infection | |
Peri-lymphatic nodules | Alveolar sarcoidosis |
Minor or major change in the distribution and severity | Chronic eosinophilic pneumonia |
Organizing pneumonia | |
Pulmonary hemorrhage | |
Arcade-like or polygonal opacities | Organizing pneumonia |
Fat density | Lipoid pneumonia |
Interlobular septal thickening and subpleural sparing | Organizing pneumonia |
Pulmonary hemorrhage | |
Involvement of other organs | Liver and bowel: PTLD |
Renal involvement: Granulomatosis with polyangiitis | |
Involvement of upper respiratory tracts and paranasal sinuses: Granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis |
PTLD: Post-transplant lymphoproliferative disorder.