The radiological spectrum of small-airway diseases.

The small airways of the lungs are an often misunderstood and confusing anatomic location teeming with an array of similar-appearing disease processes that can be daunting even to the most experienced radiologist. This article shows that an understanding of small-airway anatomy and accurate pattern recognition can allow one to determine useful clinical differential diagnoses. The ability to recognize mosaic lung attenuation, and the presence of centrilobular nodules and reticular opacities (tree-in-bud), with or without ground glass, is of critical importance in evaluating this portion of the lung. In addition, we attempt to further show how high-resolution computed tomography (HRCT) scanning has opened the deep recesses of the lung to the thoracic radiologist, allowing for a more meaningful radiologic contribution to the clinical care of patients with unexplained pulmonary symptomatology.

[1]  P. Grenier,et al.  Respiratory bronchiolitis: radiographic and CT findings in a pathologically proven case , 1998, European Radiology.

[2]  N. Müller,et al.  Spectrum of pulmonary aspergillosis: histologic, clinical, and radiologic findings. , 2001, Radiographics : a review publication of the Radiological Society of North America, Inc.

[3]  N. Müller,et al.  Mycoplasma pneumoniae pneumonia: radiographic and high-resolution CT features in 28 patients. , 2000, AJR. American journal of roentgenology.

[4]  A. Leung.  Pulmonary tuberculosis: the essentials. , 1999, Radiology.

[5]  A. Nicholson,et al.  Nonspecific interstitial pneumonia: variable appearance at high-resolution chest CT. , 2000, Radiology.

[6]  T Kozuka,et al.  Diffuse panbronchiolitis: evaluation with high-resolution CT. , 1988, Radiology.

[7]  H Itoh,et al.  Diffuse panbronchiolitis: correlation of high-resolution CT and pathologic findings. , 1992, Radiology.

[8]  M. S. Fisher,et al.  Diffuse panbronchiolitis: histologic diagnosis in unsuspected cases involving North American residents of Asian descent. , 1998, Archives of pathology & laboratory medicine.

[9]  M. Arakawa,et al.  [Bronchiolitis obliterans and no radiographic abnormalities in a patient with rheumatoid arthritis]. , 1997, Nihon Kyobu Shikkan Gakkai zasshi.

[10]  N. Müller,et al.  Pseudophysiologic emphysema resulting from severe small-airways disease. , 1998, American journal of respiratory and critical care medicine.

[11]  C. Pereira,et al.  Diffuse panbronchiolitis in Latin America. , 2000, The American journal of the medical sciences.

[12]  D A Lynch,et al.  Respiratory bronchiolitis, respiratory bronchiolitis-associated interstitial lung disease, and desquamative interstitial pneumonia: different entities or part of the spectrum of the same disease process? , 1999, AJR. American journal of roentgenology.

[13]  N L Müller,et al.  Lymphocytic interstitial pneumonia: thin-section CT findings in 22 patients. , 1999, Radiology.

[14]  Y Nakajima,et al.  Bronchiolitis obliterans with organizing pneumonia versus chronic eosinophilic pneumonia: high-resolution CT findings in 81 patients. , 2001, AJR. American journal of roentgenology.

[15]  D. Lynch,et al.  Diffuse panbronchiolitis in the United States. , 1996, American journal of respiratory and critical care medicine.

[16]  G. Ergul,et al.  Diffuse panbronchiolitis observed in a white man in Turkey. , 2000, Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG.

[17]  E J Stern,et al.  CT patterns of bronchiolar disease: what is "tree-in-bud"? , 1998, AJR. American journal of roentgenology.

[18]  J. Golden,et al.  Early bronchiolitis obliterans following lung transplantation: accuracy of expiratory thin-section CT for diagnosis. , 2000, Radiology.

[19]  E. Rosenow,et al.  Mycoplasma pneumoniae pneumonia. , 1989, Chest.

[20]  E. Patz,et al.  Pulmonary nontuberculous mycobacterial infection: radiologic manifestations. , 1999, Radiographics : a review publication of the Radiological Society of North America, Inc.

[21]  A. Nicholson,et al.  Follicular bronchiolitis: thin-section CT and histologic findings. , 1999, Radiology.

[22]  E. Kazerooni,et al.  High-resolution CT of the lungs. , 2001, AJR. American journal of roentgenology.

[23]  G. Berry,et al.  Bronchiolitis obliterans after lung transplantation: detection using expiratory HRCT. , 1998, Chest.