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Elementary Lesions

Elementary Lesions

Random Micronodulation

Characteristics

  • Micronodules with identical diameters spread at regular intervals across the two pulmonary areas without any predominance of topographical elements compared to the pleural surface, fissures, bronchovascular elements, and boundaries of the lobule

Diagnostic Orientation

  • Random micronodulations can be associated with different conditions:

    • miliary (haematogenous) tuberculosis

    • miliary (haematogenous) metastases

    • miliary mycosis (aspergillosis, candidosis)

    • virosis (herpes, Cytomegalovirus)

1.Random micronodulation

Miliary Tuberclosis

Multitude of dense micronodules spread bilaterally and ubiquitously on HRCT (A); MIP reformation (B) helps the detection of micronodules and allows to assert their random distribution.

2.Random micronodulation

Miliary Tuberclosis

Random micronodulation in an inflammatory context suggesting miliary tuberculosis.

3.Random micronodulation

Miliary Tuberclosis

MIP reformation helps confirming random micronodulation.

References

  1. Collège des Enseignants de Pneumologie. Item 206 (ex item 120). Pneumopathies interstitielles diffuses. 2013

  2. Cottin V, et al. French practical guidelines for the diagnosis and management of idiopathic pulmonary fibrosis - 2017 update. Full-length version. Rev Mal Respir 2017;34:900-68

  3. Brauner M, et al. Imagerie des pneumopathies diffuses. Press Med 2010 39: 73-84

  4. Raghu G, et al. Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med 2018;198:e44-e68