PNEUMONIA

AND
BRONCHOPNEUMONIA
PRESENTANT: JUWITA VALEN RAMADHANIA, S.KED
I4061171009
CONSULENT: DR. INDRIA FAJRIANITA SP.RAD
 PNEUMONIA

• General Consideration
• Pneumonia can be generally defined as consolidation
of lung produced by inflammatory exudate, usually
as a result of an infection agent.
• Most pneumonias produce airspace disease, either lobar
or segmental.
• Other pneumonias demonstrate interstitial disease, and
others produce findings in both the airspaces and the
interstitium.
• Most microorganisms that produce pneumonia are
spread to the lungs via the tracheobronchial tree, either
through inhalation or aspiration of the organisms.
PNEUMONIA
 PNEUMONIA
General Characteristics of Pneumonia
• Because pneumonia fills the involved airspaces or interstitial
tissues with some form of fluid or inflammatory exudate, it will
appear denser (whiter) than the surrounding normally aerated
lung.
• Airspace pneumonias appear fluffy and their margins are
indistinct.
• Airspace disease may demonstrate the silhouette sign. The silhouette
sign occurs when two objects of the same radiographic density (fat,
water, etc.) touch each other so that the edge or margin between
them disappears. It will be impossible to tell where one object
begins and the other ends.
• Pneumonia may contain air bronchograms if the bronchi
themselves are not filled with inflammatory exudate or fluid.
• When the bronchi are filled with fluid, as in bronchopneumonia, there
will be no air bronchograms present.
 AIR BRONCHOGRAM

There is airspace disease in the

left upper lobe with fluffy,
indistinct margins (red arrow)
containing air bronchograms
(white arrows). This was found
to be a staphylococcal
pneumonia.
SILHOUETTE SIGN
PATTERNS OF APPEARANCE OF PNEUMONIAS
 LOBAR PNEUMONIA
• The prototypical lobar pneumonia is pneumococcal pneumonia
caused by Streptococcus pneumoniae.
• Although we are calling it lobar pneumonia, the patient may
present with the disease before the entire lobe is involved.
• In its most classical form, the disease fills most or all of a lobe of
the lung.
• Because lobes are bound by interlobar fissures, one or more of
the margins of a lobar pneumonia may be sharply marginated.
• Where the disease is not bound by a fissure, it will have an
indistinct and irregular margin.
• Lobar pneumonias almost always produce a silhouette sign where
they come in contact with the heart, aorta, or diaphragm, and
they almost always contain air broncbogratns if they involve the
central portions of lung.
LOBAR PNEUMONIA
 SEGMENTAL PNEUMONIA
• The prototypical bronchopneumonia is caused by Staphylococcus
aureus.
• Many gram-negative bacteria, such as Pseudomonas aeruginosa,
produce the same picture.
• The disease is spread centrifugally via the tracheobronchial tree
to many foci at the same time.
• Therefore, it frequently involves several segments of the lung.
• Because lung segments are not bound by fissures, all of the
margins of segmental pneumonias tend to be fluffy and indistinct.
• Unlike lobar pneumonia, segmental bronchopneumonias produce
exudate that fills the bronchi.
• Air bronchograms are usually not present.
• Frequently, some volume loss (atelectasis) is associated with
bronchopneumonia.
SEGMENTAL ANATOMY OF THE LUNGS
SEGMENTAL PNEUMONIA
 INTERSTITIAL PNEUMONIA
• The prototypes for interstitial pneumonia are viral pneumonia
and Mycoplasma pneumoniae as well as Pneumocystis
pneumonia in patients with AIDS.
• Interstitial pneumonias tend to involve the airway walls and
alveolar septa -> reticular pattern in the lungs.
 ROUND PNEUMONIA
• Some pneumonias, mostly in children, can assume a spherical
shape on chest radiographs.
• These round pneumonias are almost always posterior in the lungs,
usually in the lower lobes.
• Causative agents are frequently Haemophilus influenzae,
Streptoeoccus, and Pneumococcus.
• A round pneumonia could be confused with a tumor mass except
that symptoms associated with infection usually accompany the
lung findings and tumors are uncommon in children.
ROUND PNEUMONIA
 CAVITARY PNEUMONIA

• The prototypical organism is Mycobacterium

tuberculosis.
• Primary TB
• Postprimary TB
• Miliary TB
 LITERATURE

• HERRING, WILLIAM. LEARNING RADIOLOGY:

RECOGNIZING THE BASIC. 1ST ED. 2007.
THANK YOU!
RADIOLOGY