Radiology – Integrated Training Initiative (R-ITI) | Paediatrics | Multiple Lung Opacities

Solitary Lung Opacity
Session Overview
Description
This session looks at the imaging of solitary pulmonary opacities in children.

Learning Objectives
By the end of this session you will be able to:

• Recognise the imaging appearances of solitary pulmonary opacities
• Provide a reasonable differential diagnosis of a solitary pulmonary opacity and relate this to the clinical features
• Advise further imaging that may be useful

Prerequisites
Before attempting this session you should have knowledge of:

• Anatomy of the chest on radiographs and computed tomography (CT)

There are a large number of causes of a solitary lung opacity in children. Acute bacterial infection (round pneumonia) is probably the most common, and the easiest to diagnose, as these children tend to have clinical features suggesting acute infection. Fig 1 shows a case of pneumonia.

Other causes of solitary lung opacities in children are quite rare and have a different differential diagnosis to those seen in adults.

Some pulmonary opacities are discovered when chest imaging is performed for other clinical reasons (i.e. follow-up of an antenatal abnormality or in a child with a malignancy).

A pulmonary opacity is usually identified because of its size or density, or a combination of the two. Opacities are usually rounded, but may be lobulated.

The aim of this session is to provide a differential diagnosis based on the imaging appearance and relevant clinical features.