SccoJld ditiotl Second Edition Radiographic Pathology TerriAnn Linn-Watson, M.Ed., ARRT (R, M), CRT (R, M, F), MTRT Professor, Radiologic Technology Program Montana State University, Billings City College Billings, Montana I ®.Wolters Kluwer Lippincott Williams & Wilkins Health Philadelphia • Baltimont • N-York • London Bu-Airu • HCJOIIICanl• Sydney • Tokyo Publisher: Angus McDonald Acquisitions Editor: Michael Nobel Senior Product Manager: Amy Millholen Production Product Manager: Priscilla Crater Design Coordinator: Stephen Druding Marketing Manager: Shauna Kelley Compositor: Integra Software Services Pvt. Ltd Printer: RR Donnelley Asia Second Edition Copyright© 2014 Lippincott Williams & Wilkins, a Wolters Kluwer business. 35 1 West Camden Street Two Commerce Square Baltimore, MD 2120 I 200 1 Market Street Philadelphia, PA 19103 Printed in China All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the aforementioned copyright. To request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19106, via email at [email protected], or via website at lww.com (products and services). Library of Congress Cataloging-in-Publication Data Linn-Watson, TerriAnn, author. Radiographic pathology I TerriAnn Linn-Watson. - Second edition. p.;cm. Includes bibliographical references and index. ISBN 978-1-4511-1214-6 I. Title. [DNLM: l. Radiography-methods. 2. Pathology-methods. WN 200] RC78 616.07'57 -dc23 2013028819 DISCLAIMER Care has been taken to confirm the accuracy of the information present and to describe gener ally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this information in a particular situation remains the professional responsibility of the practitioner; the clinical treatments described and recommended may not be considered absolute and universal recommendations. The publishers have made every effort to trace the copyright holders for borrowed material. If they have inadvertently overlooked any, they will be pleased to make the necessary arrangements at the first opportunity. To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320. International customers should ca11 (301) 223-2300. Visit Lippincott Williams & Wilkins on the Internet: http://www.lww.com. Lippincott Williams & Wilkins customer service representatives are available from 8:30am to 5:00pm, EST. 1 2 34 56 7 8 9 10 This book is dedicated to the people who have made such a positive difference in my life this past year: Kendrick, Kelly, Thomas, Christopher, and J.J. Watson Kamden Watson Jack Ryan Tom And Carolyn Flaherty Father Denis Keane Dr. Allen and Jeanette Hill Karla Uledalen A special dedication to my mother Christen W. Linn In memory of my father, Leslie L. Linn A course that presents the most commonly seen images with which to help the radiologist make a pathologies that radiographers will be imaging should diagnosis. Images of both normal and abnormal pro be an integral part of the core curriculum of evecy cesses have been presented when the pathology is student radiographer's education. Understanding how more subtle to the untrained eye. Modalicy images the pathology occurs and recognizing the appearance have been included to increase the awareness of on the diagnostic image will allow the technologist to the complementary roles that all modalities present aid the physician by adjusting images or patient posi with each other. Questions at the end of appropri tioning to best demonstrate the disease process. This ate chapters are useful for guiding discussion to help abilicy makes the technologist invaluable to the diag the student critically think about the pathologies nostic team. presented. The bulleted chapter summacy. "Recap." is an extremely student-friendly format for review Hallmarks of the Second Edition ing the important and salient points presented in the chapter. Finally, the "Tech Tip" feature high As quickly as one edition of a textbook in this field is lights something that the student should remember completely rewritten and published. the ARRT and as important to either the obtaining of a diagnostic ASRT revise and expand the curriculum for the profes radiograph or things to look for on a radiographic sion. In an effort to impress upon the student of radio image to help determine the next step in the process. logic technology the importance of lifelong learning Only the pathologies that should be recognized by and professionalism and in an effort to ease the time the technologist are presented, making the material constraints on the educator, this second edition has easier and more interesting to study. been largely expanded to be in line with the newest I am vecy excited to bring this long-awaited second curriculum guidelines. edition to radiologic technology students and instruc The chapters have been reordered to flow more tors. The publishers and I feel that the improvements in line with a semester as it advances from the basic will significantly enhance the learning curve of the to the more complex pathology. More radiographic student and turn the question "Why do I have to learn images have been added to enhance the student's pathology?" into "Wow. I know what that is and I am understanding of his or her role in providing qualicy only a student) How cool is that?!" TerriAnn Linn-Watson. M.Ed., ARRT (~ M). CRT(~ M, F), MTRT .. VII This User's Guide shows you how to the put the fea Case Studies tures of Radiographic Pathology, Second Edition, to work for you. Case Studies provide real-life applicability to obtain ing and evaluating images of pathologic conditions. Goals and Objectives bout""""' •• b.ood-""" Case Study c...1pli1l1 ind..S.. 1 wi4e"""' ofd io<Mo111d C»>l<tition.t. Th.. ..c liooua Each chapter begins with Goals and Objectives that .... d«< !be IOanllioo. d. !be baut ......Jo ... ita clwlll><ror-. s-._-.i1alb<.at~ 11111)' clearly outline the types of information students bo"fP"l'l'llftD>tatlhotimo oflril1l>, ..ttiloothm lUI)' notb e cletoc:lcd mllilla< iD lilio. Oolylhemoot..,. should expect to learn while reading and completing ....,. ....,wlcleli:ware~hm. Altbo...p the~allollldbeliarrilior<Miil.the...n-t the activities of the chapter. .-lili-ttus .... be ...... Oil I cloal aodiogrlfh, il il not! be illlel>tllmo to""""" ..... tluol..., mn~y...., ortluoloalya ~""'""""'"""from ..tvanc.d ,...... ...r lll<ly. eo...--. ofd ie-......... """"'""'"'d ie - (Fi8. 8-3) tl>at - die l<lt .....mde of die houttoNiior aniD<:rouo ill. ...tt..d.inorior lo pwh e Goals tbhleodoedred.>t 4rqv>oa.l.d!oh .a... d.i.e ,lo.<.at.io.D~ o 1f! 'bbe .-...:.!.i,o_no.f -.tio......., lflbe~ii-.......Pw"""fletr,-... develop ill an .-pt to """'11'.- 1. To review the basic tenninology related to general principles of pathology OBJEC'IlVE: Define the basic tenns related to pathology 2. To learn the difference between structural and functional diseases OBJEC'IlVE: Define functional disease and give examples OBJEC'IlVE: Define structural diaease and explain its fonnation KeyTenns Tech Tips Following the Goals and Objectives, there is a list of Throughout the chapters, Tech Tips highlight impor Key Terms for the chapter. Key Terms are also bold tant information related to obtaining a diagnostic at first mention in the chapter and defined in the radiograph and things to look for on a radiographic Glossary. image to help determine the next step in the process. e Key Terms ! TECH TIP - Abscess Assess the patient and the radiographic order. Jl Altered tissue growth the process reduees body or organ maa, decreate Anoxia the kVp; ift he process adds to the body tissue be Atrophy sure to increase the kVp. Changing the mAs is Benign neoplasm not cotteet and changes the patient dose deliv Congenital erecl. The kVp clumges the penetraticm o£ tissue. Congestion ... VIII