Box 4. Differential diagnosis of recurrent or chronic localized radiographic changes
Right middle lobe syndrome
Localized airway obstruction
Within the lumen
Congenital webs
Endobronchial foreign body
Mucus plug
Carcinoid or other pedunculated tumor
Inflammatory pseudotumor secondary to previous intubation
Within the airway wall
Localized malacia
Localized bronchiectasis (underlying cause must be sought)
Complete cartilage rings
Intramural tumor
Extrinsic compression
Congenital thoracic malformation
Enlarged cardiac chamber caused by right to left shunting, cardiomyopathy
Vascular ring, pulmonary artery sling
Lymph nodes: tuberculosis, lymphoma, other
Mediastinal or lung tumor
Fibrosing mediastinitis
Pulmonary parenchymal disease
Congenital: cystic congenital thoracic malformation
Acquired: infection in residual cystic change after a cavitating pneumonia or tuberculosis (tumor will be focal and progressive)
First manifestation of a cause of recurrent fluctuating multifocal consolidation (see Box 5)
|