Diffuse Alveolar Disease

Radiological Signs

  • Butterfly distribution / Medullary distribution
  • Lobar or segmental distribution
  • Air bronchogram
  • Alveologram
  • Confluent shadows
  • Soft fluffy edges
  • Acinar nodules
  • Rapid changes
  • No significant loss of lung volume
  • Ground glass appearance on HRCT

Useful Clinical Classification

  • Acute

  • Chronic

Distribution 

  • Cortical 

    • Eosinophilic pneumonia

    • BOOP

  • Lower lobes / Mineral oil aspiration

 

Acute Diffuse Alveolar Disease

  • Water 

    • Pulmonary edema, Cardiogenic, Neurogenic pulmonary edema

  • Blood 

    • SLE

    • Goodpasture's syndrome

    • Idiopathic pulmonary hemosiderosis

    • Wegener's granulomatosis

  • Inflammatory 

    • Cytomegalovirus pneumonia

    • Pneumocystis carinii pneumonia

    • Influenza

    • Chicken pox pneumonia

  • Fat embolism

  • Amniotic fluid embolism

  • Adult respiratory distress syndrome 

Chronic Alveolar Disease

  • Alveolar proteinosis

  • Alveolar cell carcinoma

  • Mineral oil pneumonia

  • Alveolar form of sarcoidosis

  • Alveolar form of lymphoma

  • Alveolar form of tuberculosis

  • Alveolar metastases from pancreatic cancer 

  • Desquamative interstitial pneumonia

General