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Crazy paving (medicine)

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(Redirected from Crazy paving sign) Medical sign on CT of the chest

Chest CT scan showing crazy paving pattern

Crazy paving refers to a pattern seen on computed tomography of the chest, involving lobular septal thickening with variable alveolar filling. The finding is seen in pulmonary alveolar proteinosis, and other diseases. Its name comes from its resemblance to irregular paving stones, called crazy pavings.

Causes

There are variety of causes for crazy paving patterns: infection, cancer, blood related disorders, diseases caused by inhalation of particles, and idiopathic disease. Specific lung disorders that can cause such patterns are: pneumocystis pneumonia, mucinous bronchioloalveolar carcinoma, pulmonary alveolar proteinosis, sarcoidosis, nonspecific interstitial pneumonia, organizing pneumonia, exogenous lipoid pneumonia, adult respiratory distress syndrome, and pulmonary hemorrhage syndromes.

References

  1. Ishii, Haruyuki; Trapnell, Bruce C.; Tazawa, Ryushi; Inoue, Yoshikazu; Akira, Masanori; Kogure, Yoshihito; Tomii, Keisuke; Takada, Toshinori; Hojo, Masayuki; Ichiwata, Toshio; Goto, Hajime (November 2009). "Comparative Study of High-Resolution CT Findings Between Autoimmune and Secondary Pulmonary Alveolar Proteinosis". Chest. 136 (5): 1348–1355. doi:10.1378/chest.09-0097. PMID 19892674.
  2. Holbert, J. Michael; Costello, Philip; Li, Wei; Hoffman, Robert M.; Rogers, Robert M. (May 2001). "CT Features of Pulmonary Alveolar Proteinosis". American Journal of Roentgenology. 176 (5): 1287–1294. doi:10.2214/ajr.176.5.1761287. ISSN 0361-803X. PMID 11312196.
  3. De Wever, Walter; Meersschaert, Joke; Coolen, Johan; Verbeken, Eric; Verschakelen, Johny A (April 2011). "The crazy-paving pattern: a radiological-pathological correlation". Insights into Imaging. 2 (2): 117–132. doi:10.1007/s13244-010-0060-5. ISSN 1869-4101. PMC 3259383. PMID 22347941.
  4. Rossi, Santiago E.; Erasmus, Jeremy J.; Volpacchio, Mariano; Franquet, Tomas; Castiglioni, Teresa; McAdams, H. Page (November 2003). ""Crazy-Paving" Pattern at Thin-Section CT of the Lungs: Radiologic-Pathologic Overview". RadioGraphics. 23 (6): 1509–1519. doi:10.1148/rg.236035101. ISSN 0271-5333.
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