Diffuse pulmonary hemorrhage

Last revised by Dr Rania Adel Anan on 18 Dec 2021

Diffuse pulmonary hemorrhage (DPH) is a subtype of pulmonary hemorrhage where bleeding into the lung is diffuse (cf. focal pulmonary hemorrhage). If the bleeding is into the alveolar spaces, it can be further subclassified as diffuse alveolar hemorrhage (DAH).

While the exact presentation can vary is has been classically associated with dyspnea in the setting of hemoptysis +/- iron deficiency anemia 7.

Whilst chest radiographic appearances are non-specific, there may be evidence of bilateral air-space consolidation with relative apical sparing 7.

May show areas of widespread ground glass opacification +/- crazy paving pattern 8 +/- areas of consolidation. In the subacute phase HRCT may show fine diffuse nodular densities 9-10. In later stage there may also be evidence of interlobular septal thickening due to intralymphatic accumulation of hemosiderin.

For plain radiograph and CT, in the acute phase of diffuse pulmonary hemorrhage appearances, consider:

For HRCT appearances in the subacute phase (i.e. fine nodules) consider:

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Cases and figures

  • Case 1
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  • Case 2
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  • Case 3
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  • Case 4
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  • Case 5: in a child 
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  • Case 6: Goodpasture syndrome
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