Chronic pneumonitis of infancy: high-resolution CT findings

Diffuse Lung Disease

Diffuse lung disease (DLD) comprises a diverse group of disorders characterized by widespread pulmonary parenchymal pathology and impaired gas exchange. While many of these disorders are categorized under the rubric of interstitial lung disease (ILD), some of these disorders involve the airspaces or peripheral airways in addition to, or rather than, the interstitium. Some of these disorders are present primarily in infancy or early childhood, while others that are prevalent in adulthood rarely occur in childhood. This chapter will review the classification of pediatric DLD and the characteristic imaging findings of specific disorders to facilitate accurate diagnosis and guide appropriate treatment of children with these disorders.

Pulmonary interstitial glycogenosis in the setting of lung growth abnormality: radiographic and pathologic correlation

Pulmonary interstitial glycogenosis (PIG) is a rare pediatric interstitial lung disease. We report a case of a term boy presenting with tachypnea at birth requiring supplemental oxygen. Chest radiographs followed by high-resolution CT (HRCT) demonstrated hyperinflation and diffuse interstitial markings interspersed with multiple cystic spaces. An open lung biopsy demonstrated a minor component of PIG superimposed upon poor alveolarization. PIG in the setting of lung growth abnormality might be more common than previously described. Additionally, radiographic findings associated with most pediatric interstitial lung diseases are nonspecific, and histopathologic correlation is essential for diagnosis.

Imaging of Childhood Interstitial Lung Disease

The aphorism that children are not little adults certainly applies for the imaging of interstitial lung disease. Acquiring motion-free images of fine pulmonary structures at desired lung volumes is much more difficult in children than in adults. Several forms of interstitial lung disease are unique to children, and some forms of interstitial lung disease encountered in adults rarely, if ever, occur in children. Meticulous attention to imaging technique and specialized knowledge are required to properly perform and interpret chest imaging studies obtained for the evaluation of childhood interstitial lung disease (chILD). This review will address technique recommendations for imaging chILD, the salient imaging findings in various forms of chILD, and the efficacy of imaging in the diagnosis and management of chILD.

A good outcome for a case of chronic pneumonitis of infancy

Chronic pneumonitis of infancy (CPI) is a very rare interstitial lung disease. Its pathological features differ from other types of interstitial pneumonia that occur in adults and children. The mortality rate of CPI is high, even with treatment. We report a case of a 3 month old girl diagnosed with CPI after an open lung biopsy who improved after proper treatment.

Is there a role for CT in the neonate?

Choice of imaging modalities should be based on scientific proof and best practice guidelines. However, in the neonatal age group there is a paucity of medical evidence, and imaging is often guided by local experience, availability of equipment and expertise, and by logistical factors. This paper discusses possible indications for CT in the neonate, the associated radiation protection issues, common CT findings and potential pitfalls in technique and image interpretation. Due to the particular range of abnormalities in this age group, imaging must be tailored to the individual, and should in most cases be done in specialist units.

Imaging Considerations: Interstitial Lung Disease in Children

This article provides a guide for the technique and interpretation of high-resolution chest CT of diffuse lung disease in children. Specific causes of diffuse lung disease in infants and children are reviewed as a guide to the interpretation of these images. New information, particularly the identification of surfactant protein mutations, is included. The idiopathic interstitial pneumonia classification, which is frequently applied to pediatric lung biopsy specimens, is also discussed.