samerhasna
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I think diffuse bilateral infelterate within the pulmonary baranchyme
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| mdwannabe
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diffuse airspace disease and inerstitial involvement
Edited by mdwannabe on 06/03/05 - 08:11 AM
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| samerhasna
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I think pcp is interstitial infalammation
tell me if I am wrong
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| mdwannabe
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it is both... while the inflamation is in interstitium, the P. Jeroweci is in the airspace. my guess is that you ll see both but mostly interstitial disease on x-ray and bilaterally.
Edited by mdwannabe on 06/05/05 - 10:07 AM
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| ayeshah_l
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in FA its written bilat diffuse perihilar . infilt.
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| samerhasna
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I think we miss between the pathophysiology of the disease and the CXR..........
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| mdwannabe
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the patho and pathophys and physio of any disease has its expression in clinical findings...
the PCP radiological finding is Diffuse Interstitial Infiltrates covering perihylar area as well as peripheral fields.
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| nightflight1945
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CXRay is mostly Normal in PCP pneumonia or at least we can say it is insignificant,so BAL or open lung biopsy are needed to confirm its diagnosis.
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| mdwannabe
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radiology teaching would disagree with that.
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| sofianee
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I would say that the MC findings if they are evident on X-rays are : "Diffuse interstitiel infiltrate with ground glass appearance"
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| sofianee
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I ll just rephrase my statment with more emphasis:
CXR in PCP infection can be normal or abnormal,
If abn: 2 situations:Typical findings which are mainly made of a generous & diffuse intertitiel infiltration interresting initially the hillar era then spreading out to both lower and mid part of the lung sparing the apices (usually named Butterfly infiltrate), we may find some alveolar compount which if present can mimic superimposed consolidation.
Atypical findings: can be anything as : pneumothorax,nodularities,cavities....etc
Therfore "the MC findings in a PCP CXR should be : a diffuse infiltration of the lungs"
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| mdwannabe
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Agreed
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| chemamr
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i have a question, (itīs clear the findings on a CXR in a pneumonia by PCP), how do you diagnose a pneumonia by PCP?
First a CXR, then a bronchoalveol lavage and thatīs it ???, am I ok, please answer me
Thank you
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| chemamr
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Thank you anyway. 
First itīs an CXR, later a methenamine silver or wright giemsa stain of an induced sputum for definitive diagnosis, if itīs negative, then a bronchoalverolar lavage, if itīs negative, then a transbronchial lung biopsy.
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