Scimitar

CXR findings are that of a small lung with ipsilateral mediastinal shift, and in one third of cases the anomalous draining vein may be seen as a tubular structure paralleling the right heart border in the shape of a Turkish sword (“scimitar”).

Scimitar syndrome is associated with congenital heart disease, ipsilateral diaphragmatic anomalies and vertebral anomalies

Pneumatocoele

Hydatid cyst liver

Feline esophagus

These transient lines (they disappear with a subsequent swallow)represent contraction of the muscularis mucosa. It is most commonly seen in patients with gastroesophageal reflux

Asbestosis

Alveolar microlithiasis

small, calcific density nodules spread throughout both lungs, more so in the lower zones

Pulmonary edema

Alveolar oedema manifests as ill-defined nodular opacities tending to confluence (see image with arrows). Interstitial oedema can be seen as peripheral septal lines - Kerley B lines (arrowheads). 

Grade	Description	PCWP (mmHg)
0	Normal	8 - 12
1	upper zone diversion	13 - 18
2	interstitial oedema	19 - 25
3	alveolar oedema	>25

Chondrosarcoma rib

Hydatid - water lily

Esophageal atresia, TEF

CLE

Congenital cystic adenomatoid malformation

3types:
1)type1- single/multiple cysts2-10 cms in diameter(ciliated respiratory epithelium)
2)type2-multiple cysts <2 cms in diameter(cuboidal to columnar epithelium)
3)type3-essentially solid lesions with microcysts and gland like (adenomatoid)structure

Radiographic findings-

Variable appearance ,depending on the size of cysts

Solid to multicystic mass with variable amounts of air and fluid

May cause mass effect

On ct-

Used for characterization of lesion for pre surgical planning

To identify lesions diagnosed prenatally but not evident on chest x-ray

Cyst walls and solid components demonstrate variable enhancement

mass effect demonstrated as mediastinal shift or adjacent lung compression

Will demonstrate cystic spaces even in solid appearing masses on chest radiograph

No evidence of systemic arterial blood supply

Pulmonary AVM

Aortic arch aneurysm

Congenital diaphragmatic hernia

Pleuropericardial cyst

Ganglioneuroma

Descending thoracic aortic aneurysm

Right lower lobe collapse

Mature cystic teratoma

Allergic Broncho Pulmonary Aspergillosis

FINGER IN GLOVE

On ct-appear as band like abnormalities in expected position of bronchi

Bronchiectasis-proximal bronchiectasis (characterstic finding and highly specific for ABPA)
  Distal airways remain normal and patent

Croup

AP view - loss of normal shoulders (lateral convexities) of  the subglottic  trachea secondary to subglottic  edema : steeple sign, pencil tip or inverted V sign
-Symmetric ,subglottic narrowing with narrow portion of the airway extending more inferiorly than the level of pyriform sinuses

Lateral radiograph-
Narrowing of subglottic  trachea
Loss of definition of subglottic  trachea
Hypo pharyngeal  overdistension
Normal epiglottis and aryepiglottic fold
Hypopharynx may be collapsed with distension of the lower cervical trachea - if expiratory image

The AP radiograph demonstrates bilateral narrowing of the subglottic airway, the "steeple sign" in the absence of epiglottic thickening 

Lateral radiograph shows distension of the hypopharynx (the patient's attempt at decreasing airway resistance) 

Ebstein's anomaly

BOX SHAPED HEART

Septal and posterior leaflets of  the tricuspid valve are long and redundant  -and there proximal portion is plastered to the wall of RV particularly along septal wall - result in tricuspid regurgitation

- Proximal portion of RV cavity is “atrialized” but it contracts synchronously with the ventricle 

- RV performance markedly reduced

patent  fortamen  ovale or atrial  septal defect frequently seen - results in Rt-to-lt shunt  inducing central cyanosis

Silicosis

CXR-

1) 1-3 mm round well-defined nodules in the posterior portion of upper 2/3 rd of lungs , symmetric

  -Sometimes calcified

  -With time the nodules increase in size and number and may involve all zones

2) Reticular pattern may also be noted

CT-

1) Centrilobular micronodules

   -Upper zone preponderance (spreads anteriorly and inferiorly as the disease progresses

   -Subpleurally  the nodules may cluster to form “pseudoplaques”

   -Larger nodules may calcify

Malignant mesothelioma

1) Extensive nodular or lobular thickening of the pleura which may conglomerate to form a circumferential lobular sheet of  soft tissue density encasing the lung
  - Often runs into fissures accompanied with varying amounts of pleural fluid
   * neoplastic encasement of lung fixes the mediastinum ,so  mediastinal shift away from the site of effusion is not seen in MM
 2) Ipsilateral volume loss
 3) On CT- soft tissue density of tumor tissue is easily distinguished from adjacent pleural effusion ; but when nodules are tiny the only CT feature may be pleural effusion
 4) Calcification -rare

Septic emboli

*diagnosis may be first suggested at chest CT as abnormalities may be seen on CT even before blood cultures become positive

     CXR and CT appearance-
1) Multiple pulmonary opacities - may occur in any portion of lung (but usually maximal in lower zones)
-Either round (nodular) in shape or wedge shaped densities based on pleura and pointing towards hilum (like an infarct)
-Frequently cavitate
Air bronchograms frequently seen in all types of opacity including nodular lesions on CT

2) feeding vessel sign-
  Common CT finding of both sterile and infected infarcts
  It is a distinct vessel leading to apex of  a peripheral area of consolidation
  Not specific for embolic sequelae  but seen more frequently with septic emboli and sterile thrombo-embolic infarctions than in other conditions

3) Pleural effusion and empyema - common features

Hypersensitivity pneumonitis

  CXR-

1) Ground glass opacification

2) Fine nodular or reticulonodular pattern (more prominent in sub acute phase)

   [ Lower lung predominance ]

3) Chronic cases - fibrosis with upper lobe retraction, reticular opacity, volume loss and honeycombing may be seen

HRCT-
1) Poorly defined centrilobular nodules - < 5 mm in diameter , profuse throughout the lung ,but a mid to lower lung zone predominance noted (*ground glass attenuation)
   - Usually regress with removal of exposure
2) Ground glass attenuation - most common in AHP
    - may be patchy or diffuse
    - middle lung zone predominance
    - may resolve with removal of exposure