Chapter 8.  Chest X-Ray Atlas

473

Noninfectious Causes (cont’d)

Features (may have some, none, or all)

Causes	History	Physical	Laboratory	Chest X-Ray
Sequestered	Usually	Unremarkable.	Normal WBC,	Solid nodule unless
lung	asymptomatic.		↑ ESR.	communicates with
	Productive			bronchus, then thin-walled
	cough ±			cavity ± air fluid levels.
	hemoptysis if			Usually posterior based
	communicates			segment of lower lobes
	with bronchus			(LLL > RLL). If > 3 cm,
	or if infected.			presents as mass lesion.
Histiocytosis X	Patients	Hepato-	Normal WBC,	Pneumothorax
(eosinophilic	usually 20–40	splenomegaly,	eosinophilia.	superimposed on diffuse
granuloma,	years. Usually	skin lesions,		pulmonary fibrosis. Cystic
Langerhan’s	asymptomatic.	hemoptysis		bone lesions. Usually mid/
cell histio-	Fever, cough,	(rare).		upper lung fields with
cytosis)	dyspnea in			nodules/thin-walled cysts
	some. Diabetes			or infiltrates. No hilar
	insipidus rare.			adenopathy or pleural
				effusion.

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