diffuse pulmonary hemorrhage

Diffuse pulmonary hemorrhage (DPH) is a subtype of pulmonary hemorrhage where bleeding into the lung is diffuse. If the bleeding is into the alveolar spaces this can be further subclassified as diffuse alveolar hemorrhage (DAH).

Clinical presentation

While the exact presentation can vary is has been classically associated with dyspnea in the setting of hemoptysis +/- an iron deficiency anemia .

Pathology

Associations

Radiographic features

Plain radiograph

While chest radiographic appearances are nonspecific, there may be evidence of bilateral air-space consolidation with relative apical sparing .

CT/HRCT

May show areas of widespread ground glass opacification +/- crazy paving pattern +/- areas of consolidation. In the subacute phase HRCT may show fine diffuse nodular densities . In later stage there may also be evidence of interlobular septal thickening due to intralymphatic accumulation of hemosiderin.

Differential diagnosis

For radiographic (plain radiograph and CT) in the acute phase of DPH appearances consider:

For HRCT appearances in the subacute phase (i.e. fine nodules) consider:

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