dfferential diagnosis ?

SPOT THE DIAGNOSIS

x ray chest

what is your diagnisis
give answer in form of comments

GROUND GLASS OPACITY in HRCT lung

Ground-glass opacity (GGO) is defined as increased attenuation of the lung parenchyma without obscuration of the pulmonary vascular markings on CT images
Basically it may be filling of alveoli with fluid , blood, cancer cells,pus etc or thickning of alveolar walls below spatial rtesolution in HRCT.eg pulmonary fibrosis. So ground-glass opacification may either be due to air space disease (filling of the alveoli) or interstitial lung disease (i.e. fibrosis).


Causes of Isolated Diffuse Ground-Glass Opacity


Opportunistic infections Pneumocystis pneumonia (PCP)

Cytomegalovirus pneumonia (CMV)

Herpes simplex virus pneumonia (HSV)

Respiratory syncytial virus bronchiolitis

Other

Chronic interstitial diseases
Hypersensitivity pneumonitis (HP)

Desquamative interstitial pneumonia (DIP)

Respiratory bronchiolitis interstitial lung disease (RBILD)

Nonspecific interstitial pneumonia (NSIP)

Acute interstitial pneumonia (AIP)

Lymphocytic interstitial pneumonia (LIP)

Sarcoidosis

Acute alveolar diseases
Pulmonary edema

Heart disease

Adult respiratory distress syndrome (ARDS)

Other

Diffuse alveolar hemorrhage

Other causes Drug toxicity

Pulmonary alveolar proteinosis (PAP)

Bronchiolitis obliterans with organizing pneumonia (BOOP, COP)

Bronchoalveolar carcinoma

More detail --http://www.ajronline.org/cgi/content/full/184/2/613

The anatomical location of the GGO can give a clue to etiology--
• Upper zone predominance: Respiratory bronchiolitis, PCP.
• Lower zone predominance: UIP, NSIP, DIP.
• Centrilobular distribution: Hypersensitivity pneumonitis, Respiratory bronchiolitis.