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Chest Imaging

Consolidation

By definition, diseases that produce consolidation are characterized by a replacement of alveolar air by fluid, cells, tissue, or other material. Radiographically, this term is used to describe a homogeneous increase in lung attenuation with obscuration of underlying pulmonary vessels (Fig.1); air bronchogram may be seen (see air bronchogram (V:1), Fig. 1).

Although air-space consolidation is often used synonymously with air space filling, consolidation can also result from diseases that produce an extensive, confluent interstitial abnormality, such as usual interstitial pneumonia (UIP) or sarcoidosis. The differential diagnosis of consolidation includes pneumonia of various causes, pulmonary oedema, adult respiratory distress syndrome (ARDS), atelectasis, bronchiolitis obliterans organizing pneumonia, usual interstitial pneumonia (UIP), desquamative interstitial pneumonia (DIP), idiopathic pulmonary fibrosis (IPF), hypersensitivity pneumonitis, eosinophilic pneumonia, radiation pneumonitis, bronchioalveolar cell carcinomatosis and lymphoma, alveolar proteinosis, acute interstitial pneumonia, sarcoidosis and drug reactions. Consolidation can be diffuse, patchy, or lobar in different diseases.

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Fig.1

PA chest radiograph showing bilateral patchy areas of consolidation in a patient with pulmonary haemorrhage.
Consolidation, Fig.1