Architectural distortions

Especially the occurrence of fine-linear calcifications and the in part linear distribution of the calcifications is highly suggestive of malignancy. The microcalcifications are less well seen on the MLO (b) and ML (c) views, which is predominantly caused by a slight motion blur in these images. In contrast to mass lesions and architectural distortions, visibility of microcalcifications is less affected by overlying parenchymal structures... 

Fig. 26.12a,b. continued) Acute interstitial pneumonia (AIP) in a 58-year-old patient, b Fibrotic changes with traction bronchiectasis (arrow) and architectural distortion in the late phase of acute interstitial pneumonia (AIP)... 

When sarcoidosis progresses to fibrosis, architectural distortion and traction bronchiectasis classically radiating from the hilum to the adjacent upper and lower lobes can be found. Other common CT abnor-mahties in fibrotic sarcoidosis include honeycombing, cysts, and buUa formation. Airway stenosis in sarcoidosis is usually due to extrinsic scarring, or to endobronchial granulomas, whereas lymphadenopathy alone is a rare cause of symptomatic airway narrowing. 

Honeycomb change Architectural distortion Bronchiectasis and bronchiolectasis... 

Figure 2 HRCT of a patient with IPF demonstrating classic features including heterogeneous involvement with reticulation, architectural distortion, and honeycomb changes with a paucity of ground glass opacities. The black arrows indicate traction bronchiectasis. Abbreviations HRCT, high-resolution computed tomography IPF, idiopathic pulmonary fibrosis.

Figure 5 HRCT images demonstrating prominent ground glass opacities without architectural distortion in a patient with DIP. Abbreviations HRCT, high-resolution computed tomography DIP, desquamative interstitial pneumonia.

Cysts likely reflect airway obstruction caused by peribronchiolar lymphocytic infiltration (50). Peribronchovascular and subpleural cystic airspaces may be observed in up to two-thirds of patients and may progress over time (49,51,54). Honeycomb cysts are uncommon (5-20%) (49-51) but may develop in areas of prior consolidation (50). In a study of 14 patients of LIP who had serial CT scans, 9 improved, 4 worsened, and 1 remained stable (50). Many parenchymal abnormalities were reversible (50). However, cysts or architectural distortion either worsened or did not change on follow-up (50). Additional cysts often developed in areas where centrilobular nodules had been present on initial CT scans. 

Honeycomb change Architectural distortion Micronodules Ground glass opacities Emphysema... 

Alternatively, breast cancers can be described as being invasive (i.e. they have broken into the surrounding fatty tissue of the breast). They can appear on mammograms as a mass or architectural distortion (referred as mass in the rest of this paper). A mass is defined as a space-occupying lesion seen in at least two different projections [3], M ses are described by their shape and margin characteristics. 

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