1. CHRONIC BRONCHITIS:
- Acute bronchitis does not show any X-ray findings.
- Chronic bronchitis of 3 consecutive months for more than 2 years may show:
-Linear shadows become prominent.
-Small ill defined opacities anywhere in lung.
-Wide alteration in lung markings noted.
-Emphysematous changes seen.
- It is commonest in lower zones of lings.
- In many X-ray we may not find anything conclusive.
- There may be patchy consolidations.
- In some cases dilated bronchi filled with mucus may be visualised.
- In many cases the actual wall of bronchi may be visible as thin parallel lines raditing outwards
- In some terminal dilatation may be seen giving honeycomb appearance.
- Secondary pneumonia may be seen.
- Mediastinal glands do not enlarge.
3. PRIMARY CHILDHOOD TYPE OF TUBERCULOSIS:
- Ghone focus is a pneumonic consolidation of few mm usually at periphery.
- Lesion may undergo fibrosis and may calcify
- Hilar lymph glands are enlarged.
- It may produce pneumonia and consolidation.
- It is single and homogeneous lesion.
- Cavitation is rare.
- Small pleural effusion may be noted.
4. CHRONIC PULMONARY TUBERCULOSIS.
- More common type is motting of individual shadow of 1-5 mm diameter.Shadows do not coalesce and remain discrete.
- Less commonly there may be isolated large opacities roughly circular 1/2 to 2 cm in diameter.
- Occasionally lesion may appear as areas of homogeneous consolidation.
- Mediastinal glandular enlargement does not occur.
- Lung destruction heals by fibrosis.Emphysema may also be present.
- Cavity may appear when homogeneous area of consolidation breaks down.Cavity appears in acute phase and inner margin is rough and irregular.
- Tuberculous lesion often cavitate and many of them calcify.Calcified foci are irregular in size and shape and are grouped in clusters.
- Calcification of tuberculous focus always implies some degree of healing but in some cases viable bacilli may be recovered.
5. MILIARY TUBERCULOSIS;
- Lung fields are studded by innumerable dots of opacity,varying in size from pin head to 2-3 mm.
- Normal lung marking tend to disappear.
- Initially discrete may also coalesce into areas of patchy consolidation.
- Mediastinal glands do not enlarge.
- Lung do not become fibrotic or emphysematous.
- Hypertranslucent lungs
- Horizontal ribs.
- Intercostal spaces are widened.
- Pear shaped narrow heart.
- Hilar shadows become prominent.
- Diaphragms are lowered down.
7. PRIMARY PNEUMONIA.
- The outline of individual shadows of pneumonia are hazy and indistinct.
- There is not much of loss of volume.
- when area of consolidation is breaking down and forming an abscess,the volume is slightly increased.
- Hilar glands are generally not enlarged.
- Mostly primary pneumonies resolve completely and do not leave any residual fibrosis.it completes within 3 weeks.
- Often accompained by pleural effusion.
8. LUNG ABSCESS.
- At first only a fluid level in consolidated lung is seen.
- As consolidation clears,abscess may reveal a well defined 3 to 5 mm thick wall of cavity which later on becomes thin.
- Amount of fluid varies from time to time.
- Increased lung marking but no enlargement of hilar glands seen..
9. HODGKIN`S DISEASE.
- Parayracheal glands are more commonly involved than hilar glands.
- Enlargement tends to be asymmetrical having no lobulation.
- Pulmonary appearances are pleomorphic.
- Pulmonary fibrosis is coarse linear type.
- Pleural metastasis—commonest is pleural effision specially in breast cancer.Less frequently pleural nodular metastasis is seen.
- Ribs—expansion ,localised erosion or pathological fracture is obvious.
- Mediastinal glands—tracheobronchial group is first to enlarge.
- Lung prenchyma—Canon ball metastasis .
11. HONEYCOMB LUNG.
- Cystic bronchiectasis.
- Cystic fibrosis.
- Rheumatoid lung.
- idiopathic interstitial fibrosis
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