Approach to diffuse lung diseases: dilemmas, pitfalls and tips

Diffuse parenchymal lung diseases (DPLDs) represent a large and heterogenous group of lung disorders, characterized by a variable degree of inflammation and/or fibrosis of the pulmonary parenchyma. Owing to the relatively small number and non-specific parenchymal manifestations of such a complex group of diseases, a systematic approach to the high-resolution computed tomography (HRCT) images is of paramount importance to avoid overlooking and misinterpretation of both main and ancillary findings. Imaging, however, might not be sufficient to establish a definite diagnosis, and thus the integration with clinical and histologic data is often required. This review article summarized a practical approach to DPLDs, emphasizing the importance of adopting an adequate HRCT technique, recognizing and reporting both pulmonary and extrapulmonary signs. The role of imaging in the context of the multidisciplinary approach is also discussed.