PPS 09 Radiology-Pathology Correlation of Lung Disease
Posted Jun 30 2009 12:00am
Dr. Teri Franks and Dr. Jeff Galvin, both from the AFIP, delivered a very informative presentation on rad-path correlation of lung disease. One very helpful approach is the connection between pathology and radiology patterns:
Six pathology patterns of lung disease:
Acute lung injury
Alveolar "filling", e.g. edema, fibrin, cells
Four CT patterns of lung disease:
Ground glass and consolidation
Airtrapping and cysts
The rest of the presentation presented hrCT and pathology images to correlate the basic CT patterns with the pathology patterns.
Definitions: Ground glass infiltrates: hazy areas of attenuation with airways and vasculature still visible through it Consolidation: opacification of lung parenchyma obscuring underlying detail
Radiology pattern 1, ground glass infiltrates and consolidation--correlates with acute lung injury, cellular infiltrates and/or alveolar filling
Radiology pattern 2 fibrosis (linear vs reticular opacities) with/without honeycombing--correlates with fibrosis
Radiology pattern 3--correlates with nodules/masses: cf. large/small, single/multiple
Radiology pattern 4 mosaic pattern and cysts--correlates with a variety of entities such as pulmonary HTN, lymphangioleiomyomatosis
Then overlaid on this matrix is consideration of the d/dx based on distribution and anatomic location of the lesions.
Bottom line: We pathologists interpreting lung specimens (of all types!) must be aware of these patterns as they are extremely helpful, really critical actually, in making a diagnosis (rather than a description) on lung specimens.