“ Typically affecting middle-aged men , they present with a dry cough and clubbing. There is a strong association with smoki ng. It is mostl...
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Typically affecting middle-aged men, they present with a dry cough and clubbing. There is a strong association with smoking. It is mostly primary (90%). The rest arises due to acute silicosis, haematological malignancy or in the context of infection with immunosuppression (e.g. Cryptococcus, Nocardia or Aspergillus). Characterised by the filling of airspaces with proteinaceous fluid—the interstitium is not affected.
PLAIN FILM
• Symmetrical peri-hilar ground-glass opacification, mimics pulmonary oedema ( interstitial shadowing with Kerley B lines)
• No pleural effusion or cardiomegaly
HRCT
• A crazy-paving appearance is classic (less common in secondary disease)—a combination of groundglass opacification and smooth interlobular septal thickening.
• Ground-glass opacification predominates (the ‘black bronchus’ sign is useful for demonstrating ground-glass opacification).
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