Radiological signs
Lobar or segmental distribution
Alveologram
Soft fluffy edges
Rapid changes
No significant loss of lung volume
Ground glass appearance on HRCT
Useful Clinical Classification
Acute
Chronic
Acute diffuse alveolar disease
Pulmonary edema Cardiogenic
Neurogenic pulmonary edema
SLE
Goodpasteures syndrome
Idiopathic pulmonary hemosiderosis
Inflammatory
Cytomegalo virus pneumonia
Influenza
Chicken pox pneumonia
Fat embolism
Amniotic fluid embolism
Adult respiratory distress syndrome
Chronic alveolar disease
Alveolar form of Lymphoma
Alveolar form of Tuberculosis
Desquamative interstitial pneumonia
General
Cannot tell whether there is co-existent interstitial disease.
Alveolar and interstitial pattern can be evident in different portions of lung and is of diagnostic significance
Evolution of Changes in x-ray helpful in the diagnosis.
None of the x-ray findings are specific
History and the clinical setting under which the problem is encountered is of great help in diagnosis
Presence of co-existing findings helpful e.g. Lympadenopathy etc
Options for a diagnostic procedure is based on the working diagnosis: Sputum evaluation, HRCT, Broncho-alveolar lavage, Brushings, TBB, Open lung biopsy, VAT lung biopsy, CBC, ID workup, auto-immune workup, Cardiac workup
Distribution
Cortical
Eosinophilic pneumonia
BOOP
Lower lobes / Mineral oil aspiration