Question

Reticulonodular process in *lower lobes* w/ *pleural plaques*. Associations?

Answer 1

The combination of a reticulonodular pattern with pleural plaques in the lower lobes of the lungs, particularly when Ghon complexes are visible, is highly suggestive of a past tuberculosis infection. Secondary TB is a possible association when these findings are present on the chest radiograph, especially in individuals with a history of TB, those with compromised immune systems, the elderly, or alcoholics.

Step-by-step explanation:

A reticulonodular pattern on a chest radiograph accompanied by pleural plaques could be associated with several pulmonary conditions, but in the context provided here, it suggests tuberculosis (TB). This reticulo-nodular appearance indicates a mix of linear (reticular) and nodular (small, rounded opacities) patterns which are seen in the lower lobes of the lungs. Pleural plaques are areas of fibrous thickening on the pleura that are also visible on radiographs. The combination of these findings along with a history of tuberculosis, evidenced by the healed tubercles or Ghon complexes, could indicate secondary TB or a previous exposure that has led to scarring.

Spontaneous pneumothorax is another condition that can be seen in the context of abnormal connective tissue, though it is primarily associated with the collapse of the lung and would not necessarily be indicated by the presence of reticulonodular patterns and pleural plaques alone. Pneumonia can also present with a lung infiltrate suggestive of pneumonia and could have similar radiographic appearances to those described. However, in the context provided, tuberculosis remains the most likely association with the specified radiographic changes, considering the presence of Ghon complexes, which are highly indicative of past TB infection that has healed.